LONG-TERM RESULTS OF EMERGENCY CORONARY-ARTERY BYPASS-GRAFTING

During a 20-year period, 364 patients underwent coronary artery bypass grafting (CABG) for the treatment of ischemic heart disease. Among th ese patients, 28 underwent emergency surgery. The reasons for performi ng emergency CABG were unstable angina in 15 patients, impending myoca rdial infarction in 12 patients and congestive heart failure in 1 pati ent. Eleven patients died postoperatively. Eight variables were examin ed by univariate analysis for their influence on the occurrence of a h ospital death. Lack of a history of myocardial infarction, intraaortic balloon pumping (IABP) and acute coronary occlusion were all found to be predictors of hospital death. Seventeen patients were followed up for 12 years. There was no cardiac death and actuarial survival at 12 years was 63%. The 14 survivors are now in NYHA functional class I or II. Although the operative mortality rate is high after emergency CABG , a fair prognosis can be expected if the patients survive surgery.