title: [Emergency coronary artery bypass grafting for acute coronary syndrome].
abstract: Since the drug eluting stents appeared in Japan, the indication for percutaneous coronary intervention has become wide-spread for the treatment of coronary artery disease. In the past decade, 216 patients underwent emergency/urgent coronary artery bypass grafting (CABG) in our institution, while the annual numbers of both emergency and elective CABG cases have declined. On the contrary to the decreasing number, emergency CABG patients were significantly getting older with multiple co-morbidities. Thus, off-pump CABG is likely to be beneficial for preventing postoperative complications, leading to the decreased postoperative mortality. When emergency CABG patients developed refractory myocardial ischemia and unstable hemodynamics, a percutaneous cardiopulmonary support system was quickly applicable and useful for on-pump beating CABG achieving complete surgical revascularization. For keeping satisfactory hemodynamics during CABG, communication between cardiovascular surgeons, anesthesiologists, and perfusionists is most important.
authors.affiliation: Department of Cardiovascular Surgery, Division of Critical Care Medicine, Saitama Medical Center, Jichi Medical University, Saitama 330-8503.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Yamaguchi
authors.forename: Takanori
authors.initials: T
authors.lastname: Murayama
mesh_terms: D054058:Acute Coronary Syndrome / Q000503:physiopathology / Q000601:surgery*; D000368:Aged; D000369:Aged, 80 and over; D000768:Anesthesia, General; D002315:Cardiopulmonary Bypass; D047549:Coronary Artery Bypass, Off-Pump; D004630:Emergencies; D004632:Emergency Medical Services; D005260:Female; D006801:Humans; D008297:Male; D016343:Monitoring, Intraoperative; D062645:Percutaneous Coronary Intervention; D019990:Perioperative Care; D011183:Postoperative Complications / Q000517:prevention & control