Indication and outcome in emergent coronary artery bypass graft for acute coronary syndrome

: Among 462 cases receiving coronary artery bypass graft (CABG) during the period from November 1991 to January 1999, emergency operation was performed within 24 hours for 27 cases. Male-to-female ratio was 21:6, and age of patients ranged from 50 to 83 years (average age: 65.9 years). Intra aortic balloon pumping (IABP) was used from preoperative period for 25 cases, and PCPS was used for one case. Operation was performed under cardiac arrest in 25 cases and under ventricular fibrillation in 2. Average number of grafts was 2.4 +/- 1.0 and perioperative mortality was 25.9%. The results of emergency cases were extremely low compared with mortality of palliative operation of 3.4%, whereas mortality has been improved to 12.5% (2/16) in the last two years. These results suggest that it is important for the improvement of the outcome in emergency CABG to prevent aggravation of circulatory dynamics and to shift to operation under stable conditions.