• Department of Cardiothoracic Surgery, Xinhua Hospital, Medical School of Shanghai Jiaotong University, Shanghai 200092, P. R. China;
MEIJu, Email: ju_mei63@126.com
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Objective To summarize our experience of emergency coronary artery bypass grafting (CABG) for the treatment of coronary accidents during percutaneous coronary intervention (PCI). Methods From January 2011 to January 2013, 30 patients with coronary accidents during PCI from our hospital and other hospitals received surgical treatment in Xinhua Hospital, Medical School of Shanghai Jiaotong University. There were 21 male and 9 female patients with their age of 68±11 (54-84) years. Coronary accidents included coronary artery dissection in 12 patients, coronary artery perforation in 12 patients, acute in-stent thrombosis in 2 patients, dilation balloon rupture in 1 patient and balloon retention in 1 patient, and PCI guidewire retention in 2 patients. Among the 30 patients, 8 patients received intra-aortic balloon pump (IABP) implantation preoperatively. All the patients underwent emergency CABG, including 29 patients undergoing off-pump CABG and 1 patient undergoing CABG on pump with heart beating. The patients' medical history, PCI and surgical records were retrospectively reviewed, and surgical treatment strategies, clinical outcomes and prognosis were summarized. Results The average number of grafts was 2.8±0.4. Postoperative length of ICU stay was 8.3±4.8 days, and mean hospital stay was 20.3±15.2 days. Postoperative complications included low cardiac output syndrome (LCOS) in 3 patients, tracheotomy in 2 patients, acute renal failure requiring continuous renal replacement therapy in 2 patients, and reexploration for bleeding in 1 patient. Twenty-eight were discharged, 1 patient died of multiple organ dysfunction syndrome caused by LCOS, and another patient died of refractory ventricular fibrillation. A total of 26 patients were followed up for 10.2±8.3 months and 1 patient died of stroke during the following up. Conclusion Emergency CABG can restore coronary artery blood flow quickly and provide good results for coronary accidents during PCI.

Citation: TANGMin, MEIJu, BAOChun-rong, LIUHao, ZHANGJun-wen. Emergency Coronary Artery Bypass Grafting for the Treatment of Coronary Accidents during Percutaneous Coronary Intervention. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2015, 22(1): 19-22. doi: 10.7507/1007-4848.20150005 Copy

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