Первая международная удаленная научно-практическая конференция

"Сердечно-сосудистая хирургия и ангиология - 2003"

First International Scientific Teleconference

"Cardiovascular Surgery and Angiology - 2003"

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Hitoshi Hirose, MD, FICA ¹,  Atsushi Amano, MD ²,  Akihito Takahashi, MD ³

EMERGENT SURGICAL MYOCARDIAL REVASCULARIZATION FOLLOWING PCI FAILURE

¹ Department of Cardiovascular Surgery, Shin-Tokyo Hospital, Chiba, Japan
Currently, Department of Thoracic and Cardiovascular Surgery
Cleveland Clinic Foundation, Cleveland, OH.
² Department of Cardiovascular Surgery Juntendo University Hospital, Tokyo, Japan
³ Department of Cardiovascular Surgery Cardiovascular Institute Hospital, Tokyo, Japan

Intervention failure and crash in the catheterization laboratory are surgical emergency.  We have experienced 28 cases (20 males and 8 females, mean age of 61.8) of emergent coronary artery bypass fur unstable patients immediately after intervention failure.  Preoperatively, 19 patients (71%) required support device (IABP or ECMO).

The mean number of bypass graft was 3.0 ± 1.1.  Postoperative intubation time, IABP time, and ICU stay were 18.0 hours, 19.4 hours, and 3.2 days, respectively.  There were 2 postoperative deaths (8.0%), 5 (18.5%) low output syndrome, 2 (7.4%) stroke, 1 (3.7%) respiratory failure, and 1 (3.7%) renal failure.  At the follow-up period of 3.1 ± 2.0 years, there were 3 remote death and 6 cardiac events, giving actual survival and event-free rates of 92% and 76%, respectively.

In conclusion, the outcomes of emergent surgery after intervention failure were still poor in modern era of coronary artery bypass.