Results of Isolated Emergency Coronary Bypass Surgery According to Acute Coronary Syndrome

Authors : Mustafa ALDAĞ, Bahar TEMUR, Cemal KOCAASLAN, Göktürk İPEK, Mahmut YARGI, Tolga CAN, Ufuk ÇİLOĞLU, Şebnem ALBEYOĞLU, Ergin Emin EREN

Pages : 30-36

View : 19 | Download : 9

Publication Date : 2019-04-11

Article Type : Research Paper

Abstract :Introduction: The aim of the present study was to evaluate the results of isolated emergency coronary artery bypass grafting insert ignore into journalissuearticles values(CABG); according to acute coronary syndrome insert ignore into journalissuearticles values(ACS); types in a single center with 5-year experience. Patients and Methods: A total of 138 patients who underwent emergency isolated CABG surgery from September 2009 to July 2014 in our hospital were enrolled in this retrospective descriptive study. The cohort was divided into four groups according to the type of ACS: insert ignore into journalissuearticles values(1); unstable angina insert ignore into journalissuearticles values(USAP); insert ignore into journalissuearticles values(n= 14, 10.1%);, insert ignore into journalissuearticles values(2); nonST segment elevated myocardial infarction insert ignore into journalissuearticles values(NSTEMI); insert ignore into journalissuearticles values(n= 43, 31.2%);, insert ignore into journalissuearticles values(3); ST segment elevated myocardial infarction insert ignore into journalissuearticles values(STEMI); insert ignore into journalissuearticles values(n= 65, 47.1%);, and insert ignore into journalissuearticles values(4); cardiogenic shock insert ignore into journalissuearticles values(SHOCK); insert ignore into journalissuearticles values(n= 16, 11.6%);. There were three coprimary outcomes in the study: insert ignore into journalissuearticles values(1); in-hospital and 30-day mortality rate results, insert ignore into journalissuearticles values(2); mortality analysis according to subgroups, and insert ignore into journalissuearticles values(3); to assess the performance of European System for Cardiac Operative Risk Evaluation insert ignore into journalissuearticles values(EuroScore); II in patients with ACS who underwent emergency isolated CABG. Results: No significant differences were observed between the groups with regard to demographic and preoperative risk factors. The observed 30-day total mortality rate was 15.9% insert ignore into journalissuearticles values(n= 22);. Mortality rates in the subgroups were 7% insert ignore into journalissuearticles values(n= 1); in USAP, 4.65% insert ignore into journalissuearticles values(n= 2); in NSTEMI, 15.38% insert ignore into journalissuearticles values(n= 10); in STEMI, and 68.75% insert ignore into journalissuearticles values(n= 11); in SHOCK, respectively. There was a significant difference in mortality between the groups insert ignore into journalissuearticles values(p< 0.05);. The receiver operating characteristic curve value of EuroScore II was 0.890 insert ignore into journalissuearticles values(95% Confidence Interval, 0.826-0.937);. Conclusion: The current study demonstrates that the observed mortality rate for STEMI and SHOCK patients requiring emergency CABG remains high. Moreover, EuroScore II has a good risk prediction in NSTEMI patients while significantly underestimates the mortality in the other groups.
Keywords : Acute coronary syndrome, coronary artery bypass grafting, emergency surgery, outcome, EuroScore II