Timing of coronary artery bypass grafting surgery after acute myocardial infarction /
توقيت اجراء جراحة ترقيع الشرايين التاجية بعد احتشاء عضلة القلب الحاد
Ahmed Mahmoud Fakhry Abdelhamid ; Supervised Yahia Balbaa Anwar Balbaa , Walid Gamal Eldin AbouSenna , Hesham Zayed Saleh
- Cairo : Ahmed Mahmoud Fakhry Abdelhamid , 2016
- 138 P. : charts , facsimiles ; 25cm
Thesis (Ph.D.) - Cairo University - Faculty of Medicine - Department of Cardiothoracic Surgery
Background: Optimal timing for CABG surgery after myocardial infarction (MI) remains controversial. The aim of our study was to analyze the effect of timing of CABG after acute MI on operative mortality and morbidity. Methods: This prospective study included 60 patients who underwent isolated CABG within 30 days of acute MI over 20 months (from the first of November 2014 till the end of June 2016) in Kasr Alainy 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 MI 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