Iraqi Postgraduate Medical Journal

Abstract

ABSTRACT:
BACKGROUND :
Coronary artery bypass grafting (CABG) can be divided according to it's timing into:elective, urgent, emergency and salvage.The purpose of urgent CABG is to reperfuse the coronary artery blood flow rapidly, improves areas of myocardial ischemia, repair ventricular dysfunction and prevent the spread of the infarction area. Urgent CABG has a higher morbidity and mortality than elective CABG.
OBJECTIVE:
The purpose of this study was to identify preoperative and peroperative risk factors associated with this morbidity and mortality, evaluate clinical outcomes and recommend the possible solutions.
MATERIALS AND METHODS:
This is a retrospective study that reviewed the hospital records of 50 patients who underwent urgent CABG at the Iraqi Center for Heart Diseases for three years (2008-2010). The main daignostic tools were coronary angiography and echocardiography. All underwent conventinal CABG on cardio-pulmonary bypass with cardioplegic arrest. Variables that may be related to operative risk were analaysed.
RESULTS :
Forty-three patients underwent isolated CABG, while six patients underwent postinfarction ventricular septal defect repair and one patient underwent mitral valve replacement in addition to CABG, Postoperative mortality was 20%.
CONCLUSION:
The most common cause of mortality was Low Cardiac Output Syndrome followed by Acute Renal Failure.Preoperative risk factors for perioperative mortality were age more than 65 years, preoperative cardiogenic shock and low ejection fraction below 40.
KEYWORDS: urgent CABG, postinfarction VSD, low cardiac output syndrome.