Timing of Coronary Artery Bypass Grafting Surgery after Acute Myocardial Infarction

Ahmed  Fakhry; Yahia Balbaa; Waleed G Abo Senna; Hesham Z Saleh

doi:10.35810/ects.v1i1.142

Ahmed Fakhry Department of Cardiothoracic Surgery, Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt
Yahia Balbaa Department of Cardiothoracic Surgery, Faculty of medicine, Cairo University, Giza, Egypt.
Waleed G Abo Senna Department of Cardiothoracic Surgery, Faculty of medicine, Cairo University, Giza, Egypt.
Hesham Z Saleh Department of Cardiothoracic Surgery, Faculty of medicine, Cairo University, Giza, Egypt

DOI: https://doi.org/10.35810/ects.v1i1.142

Keywords: Acute myocardial infarction, coronary artery bypass grafting, timing, hospital mortality

Abstract

Background: Optimal timing for CABG surgery after myocardial infarction remains a matter of debate. The aim of our study was to analyze the effect of timing of CABG after acute myocardial infarction on operative mortality and morbidity.

Methods: This prospective study included 60 patients who underwent isolated CABG within 30 days of acute myocardial infarction over 20 months (from the first of November 2014 till the end of June 2016) in Kasr Al-Ainy University Hospitals. Patients were divided into two groups; the early group (0 – 3 days) included 14 patients (23.3%) and the late group (4 – 30 days) included 46 patients (76.7%). The primary outcome was all-cause hospital mortality.

Results: Our study included 43 males (71.7%) and 17 females (28.3%). The mean age was 58.4 ± 7.3 years. The total mortality rate was 8.3%. Patients undergoing early CABG experienced a higher mortality rate than those undergoing late CABG (21.4% vs 4.3%, P = 0.043). Also, early CABG was associated with more postoperative complications. Cardiogenic shock and early CABG were independent risk factors of mortality.

Conclusion: CABG in the first 3 days after acute myocardial infarction was associated with high mortality and morbidity in comparison with late CABG. This suggests that CABG may best be deferred for more than 3 days after acute MI in non-urgent cases.

Author Biographies

Yahia Balbaa, Department of Cardiothoracic Surgery, Faculty of medicine, Cairo University, Giza, Egypt.

Professor of cardiothoracic surgery

Waleed G Abo Senna , Department of Cardiothoracic Surgery, Faculty of medicine, Cairo University, Giza, Egypt.

Professor of cardiothoracic surgery

Hesham Z Saleh, Department of Cardiothoracic Surgery, Faculty of medicine, Cairo University, Giza, Egypt

Associate professor of cardiothoracic surgery

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