ArticleJournal of cardiothoracic surgery2013
Immediate surgical coronary revascularisation in patients presenting with acute myocardial infarction.
Article in Journal of cardiothoracic surgery, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed, 24 citations in OpenAlex.
- Prognostic impact of preoperative atrial fibrillation in patients undergoing heart surgery in cardiogenic shock.Scientific reports · 2023Article
- Early and late outcomes of single versus bilateral internal thoracic artery revascularization for patients in critical condition.PloS one · 2021Article
- Impact of Pre-, Intra-and Post-Operative Parameters on In-Hospital Mortality in Patients Undergoing Emergency Coronary Artery Bypass Grafting: A Scarce Single-Center Experience in Resource-Scare Setting.Vascular health and risk management · 2021Article
- Early surgical myocardial revascularization in non-ST-segment elevation acute coronary syndrome.Journal of thoracic disease · 2019Article
- Outcome of Stable Patients With Acute Myocardial Infarction and Coronary Artery Bypass Surgery Within 48 Hours: A Single-Center, Retrospective Experience.Journal of the American Heart Association · 2017Article
- Optimal Timing of Surgical Revascularization for Myocardial Infarction and Left Ventricular Dysfunction.Chinese medical journal · 2017Article
- Emergency Coronary Artery Bypass Grafting: Indications and Outcomes from 2003 through 2013.Texas Heart Institute journal · 2016Article
- Clinical Characteristics and Outcomes of Patients With Myocardial Infarction and Cardiogenic Shock Undergoing Coronary Artery Bypass Surgery: Data From The Society of Thoracic Surgeons National Database.The Annals of thoracic surgery · 2016Article
- [Perioperative risk and mortality after major surgery].Der Anaesthesist · 2015Review
- Directed cardiomyogenesis of autologous human induced pluripotent stem cells recruited to infarcted myocardium with bioengineered antibodies.Molecular and cellular therapies · 2014Article
- Percutaneous extracorporeal life support for patients in therapy refractory cardiogenic shock: initial results of an interdisciplinary team.Interactive cardiovascular and thoracic surgery · 2014Article
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Authors and funding
10 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe number of patients presenting with acute myocardial infarction (AMI) and being untreatable by interventional cardiologists increased during the last years. Previous experience in emergency coronary artery bypass grafting (CABG) in these patients spurred us towards a more liberal acceptance for surgery. Following a prospective protocol, patients were operated on and further analysed.
methodsWithin a two year interval, 127 patients (38 female, age 68±12 years, EuroScore (ES) II 6.7±7.2%) presenting with AMI (86 non-ST-elevated myocardial infarction (NSTEMI), 41 STEMI) were immediately accepted for emergency CABG and operated on within six hours after cardiac catheterisation (77% three-vessel-disease, 47% left main stem stenosis, 11% cardiogenic shock, 21% preoperative intraaortic balloon pump (IABP), left ventricular ejection fraction 48±15%).
results30-day-mortality was 6% (8 patients, 2 NSTEMI (2%) 6 STEMI (15%), p=0.014). Complete revascularisation could be achieved in 80% of the patients using 2±1 grafts and 3±1 distal anastomoses. In total, 66% were supported by IABP, extracorporal life support (ECLS) systems were implanted in two patients. Logistic regression analysis revealed the ES II as an independent risk factor for mortality (p<0.001, HR 1.216, 95%-CI-Intervall 1.082-1.366).
conclusionsQuo ad vitam, results of emergency CABG for patients presenting with NSTEMI can be compared with those of elective revascularisation. Complete revascularisation obviously offers a clear benefit for the patients. Mortality in patients presenting with STEMI and cardiogenic shock is substantially high. For these patients, other concepts regarding timing of surgical revascularisation and bridging until surgery need to be taken into consideration.
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