Original Research

Emergency surgical coronary revascularization in patients with acute myocardial infarction

B.М. Todurov ^1, 2, G.I. Kovtun ¹, S.O. Sheludko ¹, L.G. Bitsadze ¹, O.V. Revenko ¹, A.O. Shpachuk ¹, O.V. Pantazi ¹, О.М. Postupalsky ¹

¹ Heart Institute of Healthcare Ministry of Ukraine, Kyiv, Ukraine 
² Shupyk National Medical Academy of Postgraduate Education, Kyiv, Ukraine 

The aim – to summarize the results of emergency revascularization in patients with acute myocardial infarction (AMI).

Materials and methods. We studied the results of treatment of 75 patients with AMI: 20 (26.9 %) patients without ST-segment elevation, 55 (73.1 %) with ST segment elevation, among them 50 men (67.4 %) and 25 women (32.4 %), average age – (62.0 ± 12.5) years. The first group consisted of 46 (61.3 %) patients with emergency coronary artery bypass surgery (CABG) performed within 6 h after coronary angiography. The second group consisted of 29 (38.7 %) patients in whom CABG was performed through in 30–45 days after emergency coronary stenting.

Results. The majority (80 %) of the first group of patients required inotropic support during more than 2 days in the postsurgery period, and in the second group the corresponding rate was 57 %. Intraaortic balloon counterpulsation was required in 26.7 % of patients in the first group and in 5.2 % in the second group. Hospital mortality in the first group was 11.9 %, in the second group – 2.6 %.

Conclusions. Patients with unstable cardiac hemodynamics or cardiogenic shock in cases where intervention or thrombolysis are unsuccessful, require emergency CABG. CABG surgery technique in patients with AMI is safe when using artificial ventricular fibrillation with intermittent aortic clamping and moderate hypothermia.

Key words: ischemic heart disease, acute myocardial infarction, emergency coronary bypass grafting, revascularization, coronary stenting.