title: Long-Term Survival and Quality of Life of Patients Undergoing Emergency Coronary Artery Bypass Grafting for Postinfarction Cardiogenic Shock.
abstract: BACKGROUND
  This study evaluated the long-term outcome of patients undergoing emergency coronary artery bypass grafting (eCABG) for cardiogenic shock after acute myocardial infarction.
  
  
  METHODS
  Sixty-seven consecutive patients underwent eCABG for cardiogenic shock at 2 European institutions during an 11-year period. Preoperative, intraoperative, postoperative, and long-term follow-up data of all patients were prospectively collected.
  
  
  RESULTS
  Hospital survival was 86% (58 of 67), with all deaths due to cardiac causes. At a mean follow-up of 78 ± 48 months (range, 1 to 153 months), 43 of the 58 patients (74%) discharged from the hospital were alive. Causes of death in 9 of the 15 follow-up deaths (60%) were noncardiac. Overall survival rate at the end of follow-up was 64% (43 of 67). Of the 43 survivors, 41 (95%) were in New York Heart Association Functional Classification I to II, ischemia free, had a Karnofsky performance status exceeding 80, and an excellent quality of life as assessed by the Seattle Angina Questionnaire. The use of cardiopulmonary bypass and the internal thoracic artery were associated with significantly better long-term survival.
  
  
  CONCLUSIONS
  The long-term survival and quality of life of patients who undergo eCABG for cardiogenic shock after acute myocardial infarction are good, and eCABG should be considered a valuable therapeutic option in this setting. The use of cardiopulmonary bypass and the internal thoracic artery at the time of the operation are strongly advocated.
authors.affiliation: Division of Cardiac Surgery, Catholic University, Rome, Italy. Electronic address: mgaudino@tiscali.it.
authors.forename: Mario
authors.initials: M
authors.lastname: Gaudino
authors.affiliation: Department of Cardiology, Université Catholique de Louvain, Mongodinne.
authors.forename: David
authors.initials: D
authors.lastname: Glineur
authors.affiliation: Division of Cardiac Surgery, Catholic University, Rome, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Mazza
authors.affiliation: Department of Cardiology, Université Catholique de Louvain, Mongodinne.
authors.forename: Spiridon
authors.initials: S
authors.lastname: Papadatos
authors.affiliation: Division of Cardiac Surgery, Catholic University, Rome, Italy.
authors.forename: Piero
authors.initials: P
authors.lastname: Farina
authors.affiliation: Clinique Saint Luc de Bouge, Namur, Belgium.
authors.forename: Pierre Yves
authors.initials: PY
authors.lastname: Etienne
authors.affiliation: Division of Cardiology, Catholic University, Rome, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Fracassi
authors.affiliation: Division of Cardiac Surgery, Catholic University, Rome, Italy.
authors.forename: Federico
authors.initials: F
authors.lastname: Cammertoni
authors.affiliation: Division of Cardiology, Catholic University, Rome, Italy.
authors.forename: Filippo
authors.initials: F
authors.lastname: Crea
authors.affiliation: Division of Cardiac Surgery, Catholic University, Rome, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Massetti
mesh_terms: D000368:Aged; D001530:Belgium / Q000453:epidemiology; D002423:Cause of Death / Q000639:trends; D001026:Coronary Artery Bypass / Q000379:methods*; D004630:Emergencies; D005260:Female; D005500:Follow-Up Studies; D017052:Hospital Mortality / Q000639:trends; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000150:complications*; D011379:Prognosis; D011788:Quality of Life; D012189:Retrospective Studies; D012770:Shock, Cardiogenic / Q000601:surgery*; D011795:Surveys and Questionnaires; D015996:Survival Rate / Q000639:trends; D013997:Time Factors