Should arterial grafts be used for urgent coronary artery bypass surgery

: It is not clear whether arterial grafts should be used for emergency or urgent coronary artery bypass grafting (CABG) because harvest of internal thoracic arteries (ITAs) is not easy under urgent conditions and the blood flow through the ITAs may be inadequate immediately after CABG. The purpose of this study was to assess whether the use of arterial grafts in urgent CABG affects the outcome adversely or not. Twenty consecutive patients who underwent urgent CABG within 48 hours following coronary angiography at our institute between July 1991 and October 1998 were reviewed. The patients who underwent CABG with associated procedures were excluded. Among these subjects, 11 patients received at least one arterial graft. Only 1 patient died of subarachnoidal hemorrhage, and the hospital mortality rate was 5.0%. According to the overall survival rate, cardiac-death-free rate, and cardiac-event-free rate, the long-term outcome was much better in the patients with arterial grafts than those with saphenous vein grafts alone. We suggest that arterial grafts should be used even for urgent CABGs since the use of arterial grafts may not affect operative results adversely and will confer better long-term benefits.