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.
