Outcome of emergency conventional coronary surgery for acute coronary syndrome due to left main coronary disease.
نویسندگان
چکیده
BACKGROUND Outcomes of emergency coronary artery bypass grafting (CABG) for acute coronary syndrome (ACS) due to left main coronary (LMT) disease remain unclear. This study aimed to assess prognoses for patients undergoing emergency CABG for ACS due to LMT disease. METHODS One hundred and four patients undergoing emergency CABG for ACS due to LMT disease were retrospectively reviewed. All patients had intra-aortic balloon pumping (IABP) support and underwent surgery within 48 hours after onset. We determined predictors for operative mortality and calculated cardiac event free, actuarial survival, and cumulative graft patency rates. RESULTS We found that 9 patients (8.7%) developed pre-operative cardiogenic shock and 7 of them required percutaneous cardiopulmonary support (PCPS). Operative mortality affected 9 patients (8.7%). Cardiac event free rate and actuarial survival rate at 10 years were 80.7 and 75.4%, respectively. Logistic regression analysis showed that pre-operative cardiogenic shock was the only predictor for operative mortality (p = 0.0146, odds 5.96). Cumulative graft patency rates for internal thoracic artery and saphenous vein (SVG) at 5 years were 92.6 and 72.4%, respectively. One year-graft patency rate for the radial artery (RA) was 100%. CONCLUSION It is still very hard to treat patients with cardiogenic shock. We suggest that immediate percutaneous coronary intervention (PCI) with mechanical supports is required prior to CABG for survival of patients with left main shock syndrome.
منابع مشابه
Acute and Long Term Outcomes of Coronary Intervention in Unprotected Left Main Lesions
Introduction : Significant left main coronary artery stenosis jeopardizes the entire myocardium of the left ventricle and has the worst prognosis of any form of coronary artery disease. Coronary-artery bypass grafting (CABG) has been considered as the standard therapeutic approach for such patients. There are limited data on the safety and effectiveness of percutaneous coronary intervention (PC...
متن کاملCorrelation between the Level of Creatinine, Serum Cardiac Troponines and Left Ventricle Function Tests in Patients with Chronic Renal Diseases without Acute Coronary Syndrome
Background and Objectives: The aim of this study was to survey the relationship between the level of creatinine,cardiac troponins serum and the function of the left ventricle in patients with kidney insufficiency,without acute coronary syndrome. Materialsand Methods:The sample was150 patients with nondialysis chronic kidney disease without acute coronary syndrome, hospitalized at I...
متن کاملDoes it require to exclude cardiobiliary reflex in every acute coronary syndrome follow up patient with bedside ultrasound on emergency department
In emergency department, physicians can diagnose pulseless electrical activity, asystole, pericardial effusions, ischemic heart disease, wall motion abnormalities, valvular cardiac disease volume status or global cardiac function evaluating with electrocardiographic findings or using bedside c...
متن کاملTreatment seeking behavior and related factors in patients with acute coronary syndrome
Abstract Introduction: Acute Coronary syndrome is one of the most diagnosed and causes of death in the world, and treatment seeking behavior at the time of onset of symptoms and time spend on arriving to hospital is important for these patients, as it effects treatment and prognosis Objective: The aim of this study was to determine treatment seeking behavior and related factors in p...
متن کاملEmergency coronary artery bypass grafting for left main shock syndrome.
OBJECTIVE Acute myocardial infarction (AMI) complicated by cardiogenic shock and left main coronary artery disease (left main shock syndrome) shows high morbidity, and whether early coronary artery bypass grafting (CABG) improves the clinical outcome remains unclear. METHODS Six consecutive patients (mean age, 61.6 years) with MI complicated by left main shock syndrome underwent emergency CAB...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
عنوان ژورنال:
- Annals of thoracic and cardiovascular surgery : official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia
دوره 12 1 شماره
صفحات -
تاریخ انتشار 2006