Is Coronary Bypass Operation More Risky in Patients Undergoing Previous Percutaneous Coronary Intervention?
Rezan Aksoy, Mutlu Şenocak, Didem Güngör Arslan, Yavuz Şensöz, Fatih Özdemi̇r, Ahmet Yavuz Balcı, Murat Sargın, Uğur Kısa, İbrahim Yekeler
Keywords: Coronary bypass, percutaneous coronary intervention; cardiopulmonary bypass; mortality
OBJECTIVE: In this study we compare the factors affecting mortality and morbidity of the patients had coronary artery bypass graft (CABG) with/without percutaneous coronary intervention (PCI) prior to the CABG operation.METHODS: In our study a total of 214 patients who underwent CABG in our hospital between January 2006-2008 were included. They were divided into two groups as A and B. In group A, 135 patients in whom CABG was performed after PCI (mean age 52.5±8.8 years) were included; in group B, 79 patients in whom CABG was performed without any coronary intervention (mean age 51.8±8.8 years) were included. Both groups were evaluated in terms of demographic characteristics, comorbid diseases and medications, preoperative ejection fraction (EF) and functional capacity, durations of preoperative cardiopulmonary bypass (CPB) and cross clamp, number of distal bypass, whether bypass was performed on the coronary artery undergoing PCI, inotropic agent or intra-aortic balloon pump support at the time of referring to postoperative intensive care unit (ICU), duration of postoperative ICU stay and complications.RESULTS: Of the patients, 85% were males and 15% were females. In 73% (n=98) of the patients undergoing CABG following PCI, bypass was performed also on the artery undergoing PCI. The rate of malignant arrhythmia was higher in the group A in which CABG was performed following PCI as compared to the group B (8% (n=11) in the group A, 1% (n=1) in the group B). The rate of development of cerebrovascular event (CVE) was 4% (n=5) in the group A and 1% (n=1) in the group B. Postoperative mortality was 15% (n=22) in the group A and 3% (n=2) in the group B.CONCLUSION: Although PCI may be a life-saving procedure in patients presenting with acute myocardial infarction, some serious complications may occur during the procedure. So an urgent surgical intervention may be necessary. In this study, mortality and morbidity of the CABG procedures performed after PCI are reported to be high.