Trends in emergency coronary artery bypass grafting after percutaneous coronary intervention, 1994-2003

The Annals of Thoracic Surgery
Constance K HaanT Bruce Ferguson

Abstract

In the last decade, percutaneous coronary intervention (PCI) has undergone profound changes in techniques used to achieve revascularization and in patient selection. We examine trends in emergency surgical revascularization after PCI. Using The Society of Thoracic Surgeons National Cardiac Surgery Database, we examined patients undergoing coronary artery bypass grafting within 6 hours of PCI from 1994 to 2003. Stratifying into groups of patients who had and had not suffered myocardial infarction within 24 hours of PCI followed by coronary artery bypass grafting (CABG), we tracked trends in characteristics, predicted risk, and clinical outcomes. The proportion of isolated CABG procedures done emergently after PCI decreased over 1994 to 1999 from 3,357 of 115,679 (2.9%) to 1,227 of 155,831 (0.8%), remaining stable through 2003. Those suffering myocardial infarction within 24 hours made up a constant proportion of isolated CABG as emergency after PCI (3,352 of 1,042,864; 0.3%) since 1997. Over the decade, the preoperative risk profile worsened, including more elderly patients and more with cerebrovascular disease and congestive heart failure. Operative mortality among these patients has risen with time (from 8.0% to 9.3%; p < 0.00...Continue Reading

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Citations

May 15, 2013·Interactive Cardiovascular and Thoracic Surgery·Sven M AlmdahlStein E Rynning
Jul 14, 2011·Current Cardiology Reports·Yuri B Pride, C Michael Gibson
Mar 17, 2010·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Luis LandinJavier Ibañez
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Jun 29, 2012·The Journal of Thoracic and Cardiovascular Surgery·Manuel CaceresHarvey Edward Garrett
Feb 22, 2011·The Journal of Thoracic and Cardiovascular Surgery·Manjula MagantiVivek Rao
Jan 28, 2010·The Annals of Thoracic Surgery·Manuel CaceresHarvey Edward Garrett
Oct 27, 2009·The Journal of Thoracic and Cardiovascular Surgery·Mohammad Reza MovahedRadhakrishnan Ramaraj
Aug 23, 2006·ANZ Journal of Surgery·Brian F Buxton
Jan 24, 2009·The Annals of Thoracic Surgery·Xiumei SunSteven W Boyce
Jul 30, 2010·The Annals of Thoracic Surgery·Martin CzernyMichael Grimm
Apr 25, 2006·The Annals of Thoracic Surgery·Hendrick B Barner
Nov 20, 2015·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Tomas A AxelssonTomas Gudbjartsson
Mar 21, 2015·Journal of Cardiothoracic and Vascular Anesthesia·Fausto BiancariGiovanni Mariscalco
May 8, 2007·Journal of the American College of Cardiology·Robert H Jones
Jun 6, 2009·Critical Pathways in Cardiology·Ezra A Amsterdam

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