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(Circulation. 2002;106:e9045.)
© 2002 American Heart Association, Inc.

Cardiovascular News

Ruth SoRelle, MPH

Circulation Newswriter

An extract of the first 250 words of the full text is provided, because this article has no abstract.

Need for Emergency CABG Decreases, But Morbidity and Mortality Remain High

In an era in which interventional cardiologists are pushing the envelope in the kinds of ischemia they can treat, emergency coronary artery bypass surgery has become more rare, according to researchers from the Cleveland Clinic Foundation in Cleveland, Ohio, in a report in this week’s Circulation (Circulation. 2002;106:2346–2350).

The researchers, led by Niranjan Seshadri, MD, from the clinic’s Department of Cardiology, reviewed 18 593 percutaneous interventions performed at the Cleveland Clinic from 1992 through 2000. Emergency coronary artery bypass surgery was performed in 113 (0.61%) patients.

The reasons for the emergency surgery included:

Extensive dissection in 61 patients (54%)

Perforation/tamponade in 23 patients (20%)

Recurrent acute close in 23 patients (20%)

However, the percentage of emergency surgeries performed decreased from 1.5% of all percutaneous interventions performed in 1992 to 0.14% in 2000. Predictors of the need for emergency surgery included the worst American College of Cardiology/American Heart Association scoring of the intervened lesion and female genders. History of prior coronary artery bypass surgery and use of stents resulted in the need for emergency CABG.

Of the patients who underwent emergency CABG, 17 (15%) died in-hospital, 14 (12%) suffered perioperative Q-wave myocardial infarctions, and 6 (5%) had cerebrovascular accidents.

The Foreboding of Cardiac Troponin I
Cardiac troponin I can aid physicians in identifying the risk of short-term mortality and perioperative myocardial infarction in patients who are undergoing or have undergone vascular surgery, according to researchers from Johns Hopkins University School of Medicine in Baltimore, Md, in a report in this week’s issue of Circulation (. . . [Full Text of this Article]