Coronary artery bypass grafting for acute myocardial infarction in stent ERA

Ann Thorac Cardiovasc Surg. 2011;17(3):267-72. doi: 10.5761/atcs.oa.10.01590.

Abstract

Purpose: We evaluated a treatment strategy for acute myocardial infarction (AMI) that percutaneous coronary intervention (PCI) is performed on a culprit lesion unless the culprit is an unprotected left main trunk. Emergent coronary artery bypass grafting (CABG) is done when the culprit is a left main trunk and a mechanical complication exists.

Methods: From 1997 to 2008, 22 and 232 patients underwent CABG for AMI and non-AMI, respectively. Of the 22 patients of AMI, PCI was performed in 12 patients and not performed in 10 patients before surgery. We investigated complication, intubation period, in-hospital mortality and hospitalization period.

Results: No in-hospital mortality was observed in all 22 AMI patients. There was no difference in in-hospital mortality and complication between the AMI and the non-AMI patients. No significant difference was found in hospital stay, complication, intubation period, in-hospital mortality and hospitalization period between patients who received preceding PCI and not.

Conclusions: These results suggest that our treatment strategy is reasonable. Further studies will be warranted to clarify the role of preceding PCI.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Angioplasty, Balloon, Coronary / adverse effects
  • Angioplasty, Balloon, Coronary / instrumentation*
  • Angioplasty, Balloon, Coronary / mortality
  • Coronary Artery Bypass* / adverse effects
  • Coronary Artery Bypass* / mortality
  • Female
  • Hospital Mortality
  • Humans
  • Intubation, Intratracheal
  • Japan
  • Length of Stay
  • Male
  • Middle Aged
  • Myocardial Infarction / mortality
  • Myocardial Infarction / surgery
  • Myocardial Infarction / therapy*
  • Risk Assessment
  • Risk Factors
  • Stents*
  • Time Factors
  • Treatment Outcome