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ORIGINAL ARTICLE

Off-Pump Coronary Artery Bypass for Emergency Myocardial Revascularization

Ahmad K Darwazah, FRCS, Raed AH Abu Sham’a, MD1, Ismail Isleem, MRCP1, Basel Hanbali, MRCP1, Bashar Jaber, MD1

Department of Cardiac Surgery
1 Department of Cardiology, Makassed Hospital, Jerusalem, Israel

Ahmad K Darwazah, FRCS, Tel: +972 2 6270222, Fax: +972 2 628839, Email: darwaz30{at}hotmail.com, Department of Cardiac Surgery, Makassed Hospital, Jerusalem, PO Box 19482, Israel.

ABSTRACT

Emergency coronary artery bypass is associated with increased operative mortality. The objective of this study was to evaluate the efficiency and safety of off-pump emergency coronary artery bypass, and to compare the outcome with that of the conventional on-pump procedure. Data of 79 patients who underwent emergency isolated coronary artery bypass were reviewed retrospectively; 45 had off-pump coronary bypass and 34 had conventional surgery. In the off-pump group, mean ejection fraction was significantly lower (28% ± 9% vs. 39% ± 10%), and there were fewer grafts per patient (1.8 ± 0.7 vs. 3.2 ± 0.8). Early mortality was higher in the conventional surgery group (14.7% vs. 8.9%), but late mortality was similar in both groups. Patients who had on-pump surgery had lower rates of recurrent angina (16% vs. 34%) and symptoms of heart failure (20% vs. 51%). Re-hospitalization was more common in off-pump patients, but cardiac re-interventions were similar. There was no significant difference in 5-year survival rates. The results of off-pump coronary bypass were better than the preoperative predicted EuroSCORE, thus it was concluded that patients treated on an emergency basis should have an off-pump revascularization procedure.

Key Words: Cornoary Artery Bypass • Off-Pump • Emergencies

Asian Cardiovasc Thorac Ann 2009; 17:133-138
© 2009 by SAGE Publications
DOI: 10.1177/0218492309103288




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