Short Term Outcome of Urgent Coronary Artery Bypass Grafting (CABG) Surgery

Background and aim of the study: Outcomes of emergency coronary artery bypass grafting (CABG) for acute coronary syndrome (ACS) due to left main coronary (LM) disease remain unclear. This study aims to assess the short term Outcome for patients undergoing Urgent CABG, due to LM disease; as assessed by relief of symptoms and 6 months improvement of EF. Methods: This study included 60 patients that underwent urgent coronary artery bypass grafting. Patients were divided into three groups according to the pre operative ejection fraction (EF). The three groups were compared regarding preoperative, operative, and postoperative Echo measurement of Ejection fraction and relief of symptoms. Results: 70% of our cases were male with mean age of 52.2 yr (range, ±7.19 years), no clinical significance between preoperative comorbidities in relation between 3 groups and the postoperative outcome, the risk factors for our patients are Preoperative myocardial infarction (MI), hemodynamic (HD) instability specially in group C and in turn intraoperative risk is; prolonged Cardiopulmonary bypass time and cross clamp time, while during the intensive care unit stay; postoperative bleeding, MI, prolonged ventilation time and extended ICU stay. The total mortality rate is 8.3% form our patients. Postoperative echocardiography just before discharge and 6 months later showed significant improvement of EF especially for patient showing preoperative instability and MI. Conclusion: The present study demonstrated that patients undergoing Urgent CABG have a significant higher preoperative risk especially with myocardial impairment, despite the higher mortality rate 12%, a favorable clinical outcome can be expected if patients survive. Key words: Urgent CABG, LM disease, ACS, LV impairment. Abbreviations: ACS: acute coronary syndrome; CABG: Coronary artery bypass surgery; CASS: Coronary Artery Surgery Study; CCS: Canadian Cardiovascular Society; COPD: Chronic obstructive lung disease; DM: Diabetes Mellitus; EF: Ejection fraction; HD: Hemodynamic; HTN: Hypertension; IABP: intra-arotic balloon pump; LAD: left anterior descending artery; LCX: left circumflex artery; LM: left main coronary artery disease; LV: Left ventricle; MI: Myocardial infarction; NYHA: New York Heart Association; PCI: percutaneous coronary intervention; RCA: Right Coronary Artery; WMSI: wall motion score index