Off-Pump Coronary Artery Bypass Grafting Surgery in Early Stage Myocardial Infarction Treatment

Authors

  • Ahmet Cekirdekci
  • Mustafa Emmiler
  • Cevdet U?ur Koço?ullari

DOI:

https://doi.org/10.1532/HSF98.20071172

Abstract

We evaluated the surgical results of off-pump coronary artery bypass grafting (OPCAB) performed within the first 12 h of infarction in patients with acute myocardial infarction. From January 2005 to January 2007, emergency coronary artery bypass grafting without cardiopulmonary bypass was performed in 56 patients with acute coronary syndromes. The mean age was 62.9 (range, 51-86) years. All patients underwent OPCAB via sternotomy.

An average of 2.5 ± 1.1 grafts per patient were performed. The mortality rate was 7.1% (4 of 56 patients). One patient suffered from postoperative stroke (1.7%), and 3 (5.3%) needed hemofiltration for acute renal failure. Postsurgery elective coronary angiography (n = 21) showed no significant stenosis. These results indicate that emergency OPCAB can be applied to patients with acute myocardial infarction with low morbidity and mortality and excellent early results.

References

Angelini GD, Taylor FC, Reeves BC, Ascione R. 2002. Early and midterm outcome after off-pump and on-pump surgery in Beating Heart against Cardioplegic Arrest Studies (BHACAS 1 and 2): a pooled analysis of two randomised controlled trials. Lancet 359:1194-9.nAscione R, Lloyd CT, Underwood MJ, Lotto AA, Pitsis AA, Angelini GD. 2000. Inflammatory response after coronary revascularization with or without cardiopulmonary bypass. Ann Thorac Surg 69:1198-04.nChen-Scarabelli C. 2002. Beating-heart coronary arteries bypass graft surgery: indications, advantages, and limitations. Critical Care Nurse 22:44-58.nCleveland JC, Shroyer AL, Chen AY, Peterson E, Grover FL. 2001. Off-pump coronary arteries bypass grafting decreases risk-adjusted mortality and morbidity. Ann. Thorac. Surg. 72:1282-8.nCreswell LL, Moulton MJ, Cox JL, Rosenbloom M. 1995. Revascularization after acute myocardial infarction. Ann Thorac Surg 60:19-26.nCurtis JJ, Walls JT, Salam NH, et al. 1991. Impact of unstable angina on operative mortality with coronary revascularization at varying time intervals after myocardial infarction. J Thorac Cardiovasc Surg 102: 867-72.nEagle KA, Guyton RA, Davidoff R, et al. American College of Cardiology; American Heart Association. 2004 ACC/AHA Task Force on Practice Guidelines: ACC/AHA 2004 guideline update for coronary artery bypass graft surgery. Circulation 110:340-437.nIzumi Y, Magishi K, Ishikawa N, Kimura F. 2006. On-pump beating-heart coronary artery bypass grafting for acute myocardial infarction. Ann Thorac Surg 81: 573-6.nLee DC, Oz MC, Weinberg AD, Ting W. 2003. Appropriate timing of surgical intervention after transmural acute myocardial infarction. J Thorac Cardiovasc Surg 125: 119-20.nMohr R, Moshkovitch Y, Shapira I, Amir G, Hod H, Gurevitch J. 1999. Coronary artery bypass without cardiopulmonary bypass for patients with acute myocardial infarction. J Thorac Cardiovasc Surg 118: 50-6.nNunley DL, Grunkemeier GL, Teply JF, et al. 1983. Coronary bypass operation following acute complicated myocardial infarction. J Thorac Cardiovasc Surg 85:485-91.nOchi M, Hatori N, Saji Y, Sakamoto S, Nishina D, Tanaka S. 2003. Application of off-pump coronary artery bypass grafting for patients with acute coronary syndrome requiring emergency surgery. Ann Thorac Cardiovasc Surg 9:29-35.nPuskas JD, Williams WH, Duke PG et al. 2003. Off-pump coronary artery bypass grafting provides complete revascularization with reduced myocardial injury, transfusion requirements and length of stay: a prospective randomized comparison of two hundred unselected patients undergoing off-pump versus conventional coronary artery bypass grafting. J Thorac Cardiovasc Surg 125:797-808.nRastan AJ, Eckenstein JI, Hentschel B, et al. 2006. Emergency coronary artery bypass graft surgery for acute coronary syndrome beating heart versus conventional cardioplegic cardiac arrest strategies. Circulation 114:I477-85.nRiha M, Danzmayr M, Nagele G, et al. 2002. Off-pump coronary artery bypasses grafting in EuroScore high and low risk patients. Euro J Cardiothoracic Surg 21:193-8.nSabik JF, Gillinov AM, Blackstone EH, et al. 2002. Does off-pump coronary surgery reduce morbidity and mortality? J Thorac Cardiovasc Surg 124:698-707.nVlassov GP, Deyneka CS, Travine NO, Timerbaev VH, Ermolov AS. 2001. Acute myocardial infarction: OPCAB is an alternative approach for treatment. Heart Surg Forum 4:147-50.nYokoyama T, Baumgartner F, Gheissari A, Capouya ER, Panagiotides GP, Declusin RJ. 2000. Off-pump versus on-pump coronary bypass in high risk subgroups. Ann Thorac Surg 70:1546-50.nWan S, Izzat MB, Lee TW, Wan IYP, Tang N, Yim APC. 1999. Avoiding cardiopulmonary bypass in multivessel CABG reduces cytokine response and myocardial injury. Ann Thorac Surg 68:52-7.nWan IY, Arifi AA, Wan S, et al. 2004. Beating heart revascularization with or without cardiopulmonary bypass: evaluation of inflammatory response in a prospective randomized study. J Thorac Cardiovasc Surg 127:1624-31.nWan S, LeClerc JL, Vincent JL. 1997. Inflammatory response to cardiopulmonary bypass: mechanisms involved and possible therapeutic strategies. Chest 112:697-702.n

Published

2008-02-12

How to Cite

Cekirdekci, A., Emmiler, M., & Koço?ullari, C. U. (2008). Off-Pump Coronary Artery Bypass Grafting Surgery in Early Stage Myocardial Infarction Treatment. The Heart Surgery Forum, 11(1), E13-E16. https://doi.org/10.1532/HSF98.20071172

Issue

Section

Articles

Most read articles by the same author(s)