Early Result of Surgical Revascularization for Acute Myocardial Infarction

Chee, Hyun Keun; Lee, Weon Yong; Kim, Eung Joong; Doo, Young Cheol; Han, Kyoo Rok; Oh, Dong Jin; Rim, Chong Yun

Abstract

BACKGROUND AND OBJECTIVES
There are relatively few studies that have evaluated the optimal timing, risk of mortality, and outcome for patients with coronary artery bypass graft surgery (CABG) performed in the setting of acute myocardial infarction (AMI).
MATERIALS AND METHODS
We reviewed our 18 patients who underwent CABG within 14 days after AMI, between June 1994 and June 1997. Thirteen of the patients were male and 5 were female. Their ages ranged from 41 to 77 years (mean age, 60.6+/-10.4 years), and the amount of time betweenAMIandCABGrangedfrom4hoursto14days (meantime,7.0+/-4.7days).Therewere11 anteroseptal infarctions and 7 inferior wall infarctions. Eleven patients had transmural infarctions and 7 had subendocardial infarctions. Indications of operations were postinfarction angina, cardiogenic shock and intractable ventricular arrhythmia. Six patients required preoperative intra-aortic balloon pump (IABP) support, and 3 additional patients required IABP to be separated from cardiopulmonary bypass. An average of 3.4+/-0.5 vessels per patient were bypassed.
RESULTS
The early mortality rate for these 18 patients was 5.6% and late mortality rate was 5.9%, and 2-year actuarial survival rates were 89.5%. Univariate analysis of mortality showed that an ejection fraction less than 30% was associated with risk factor (p value=0.016 ). Age, sex, time to CABG, emergency operations, locations of infarctions were not significant.
CONCLUSION
Although our studies have weak points in that there was only a small number of patients and the lack of long-term results, we could conclude that early myocardial revascularization is relatively safe after AMI for those individuals with an ejection fraction greater than 30%.