RESUMO
One of the serious complications followingcoronary artery bypass surgery is postoperative acute myocardial infarction commonly due to graft thrombosis, kinking, or spasm. Two recommended approaches for management of this event includeRescue percutaneous coronary intervention (PCI) and urgent open heart surgery. In the present case series, we described and compared early and long-term results of rescue PCI and reoperation in patients with three-vessel coronary artery disease undergoing CABG postoperatively and suffered acute myocardial infarction.
Assuntos
Ponte de Artéria Coronária/efeitos adversos , Doença da Artéria Coronariana/cirurgia , Tomada de Decisões , Infarto do Miocárdio/etiologia , Intervenção Coronária Percutânea/métodos , Complicações Pós-Operatórias/cirurgia , Procedimentos Cirúrgicos Cardíacos/métodos , Angiografia Coronária , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Infarto do Miocárdio/diagnóstico , Infarto do Miocárdio/cirurgia , Complicações Pós-Operatórias/diagnóstico , Complicações Pós-Operatórias/etiologia , Reoperação , Estudos RetrospectivosRESUMO
BACKGROUND: This study aimed to evaluate the accuracy of Euroscore (European System for Cardiac Operative Risk Evaluation) in predicting perioperative mortality after cardiac surgery in Iranian patient population. METHODS: Data on 1362 patients undergoing coronary bypass graft surgery (CABG) from 2007 to 2009 were collected. Calibration was assessed by Hosmer-Lemeshow goodness-of-fit. Area under the curve (AUC) was used to assess score validity. Odds ratios were measured to evaluate the predictive value of each risk factor on mortality rate. RESULTS: The overall perioperative in hospital mortality was 3.6% whereas the Euroscore predicted a mortality of 3.96%. Euroscore model fitted well in the validation databases. The mean AUC was 66%. Mean length of intensive care unit (ICU) stay was 2.5 ± 2.5 days. Among risk factors, only left ventricular dysfunction, age and neurologic dysfunction were found to be related to mortality rate. CONCLUSIONS: Euroscore did not have acceptable discriminatory ability in perioperative in hospital mortality in Iranian patients. It seems that development of a local mortality risk scores corresponding to our patients epidemiologic characteristics may improve prediction of outcome.
