Emergency Coronary Revascularization

Abstract

The safety net of emergency coronary artery bypass can be used effectively to salvage most patients who are at risk. The concept of immediate re-perfusion to save jeopardized, but still viable, ischemic myocardium is fast gaining clinical acceptance.

Because of significantly increased graft patency and long term survival, the internal thoracic artery (ITA) has been considered as the bypass conduit of choice. Yet there has been some reductance to utilize the ITA for surgical revascularization until recent years especially in emergency situations.

In recent years, emergency coronary artery grafting (CABG) has become an important part of most cardiac surgery programs. The operative mortality for emergency CABG has been the subject of several reports leading to a general impression that surgical revascularization in this setting can be carried out with only moderate risk. There is a considerable evidence to indicate that surgeons can anticipate an operative mortality in the range of 5% for such patients. The present study was undertaken to address these concerns and to evaluate the current results of emergency CABG.