Urgent coronary bypass surgery for failed percutaneous coronary intervention in the stent era: Is backup still necessary?

Shubrooks, Samuel J.; Nesto, Richard W.; Leeman, David; Waxman, Sergio; Lewis, Stanley M.; Fitzpatrick, Philip; Dib, Nabil

doi:10.1067/mhj.2001.116077

Cited by 30 publications

(22 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…10 There has been an additional decline in the reported prevalence of emergency CABG in the 1990s. In a study of 5655 patients undergoing PCIs by Shubrooks et al, 11 emergency CABG was required in 2.2% of the cases in 1992 to 1993 and 0.6% of the cases in 1997. We report a significant decline in the prevalence of emergency CABG from 1.5% in 1992 to 0.14% of all PCIs in 2000 in a single-center tertiary care setting (Figure 1).…”

Section: Discussionmentioning

confidence: 99%

“…[2][3][4][5][6][7][8][9] In the stent era, in-hospital complications after emergency CABG have remained high. In the study by Shubrooks et al, 11 mortality and nonfatal Q-wave myocardial infarctions occurred in 29% and 14% of the cases, respectively, in 1997. In our study, in-hospital mortality and Q-wave myocardial infarction were 21% and 0%, respectively, from 1997 through 2000 compared with 13% and 17%, respectively, from 1992 through 1996.…”

Section: Seshadri Et Al Emergency Coronary Bypass Surgery In the Presmentioning

confidence: 99%

See 1 more Smart Citation

Emergency Coronary Artery Bypass Surgery in the Contemporary Percutaneous Coronary Intervention Era

et al. 2002

View full text Add to dashboard Cite

Background-Since the advent of percutaneous coronary interventions (PCIs), technological advances, adjunctive pharmacotherapy, and increasing operator experience have contributed to lowering the occurrence of major complications. However, emergency coronary artery bypass surgery (CABG) for failed PCI is still associated with important morbidity and mortality, even in the era of coronary stenting. We sought to determine the prevalence, indications, predictors, and complications of emergency CABG after PCI in the past decade. Methods and Results-We reviewed 18 593 PCIs performed from 1992 through 2000. There was a need for emergency CABG in 113 (0.61%) cases. The major indications were extensive dissection (nϭ61, 54%), perforation/tamponade (nϭ23, 20%), and recurrent acute closure (nϭ23, 20%). Prevalence of emergency CABG decreased from 1.5% of PCIs in 1992 to 0.14% in 2000 (PϽ0.001). Independent predictors of the need for emergency CABG included the worst ACC/AHA scoring of the intervened lesion (PϽ0.001) and female sex (Pϭ0.028), whereas history of prior bypass surgery and use of stents resulted in a decreased need for emergency CABG (PϽ0.001 for both). In patients undergoing emergency CABG, there were 17 (15%) in-hospital deaths, 14 (12%) perioperative Q-wave myocardial infarctions, and 6 (5%) cerebrovascular accidents. Conclusions-The need for emergency CABG has considerably decreased over time. Risk factors include female sex and a higher ACC/AHA score of the intervened lesion. However, morbidity and mortality of emergency CABG remain high even in the new millennium.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Seshadri Et Al Emergency Coronary Bypass Surgery In the Presmentioning

confidence: 99%

Emergency Coronary Artery Bypass Surgery in the Contemporary Percutaneous Coronary Intervention Era

et al. 2002

View full text Add to dashboard Cite

show abstract

“…With the advent of intracoronary stenting, there has been a decrease in the need for emergency CABG ranging between 0.4% and 2% (49,305,(338)(339)(340)(341)(342). Not surprisingly, emergency CABG surgery for a patient with an occluded or dissected coronary artery is associated with a higher mortality than elective surgery (146,(343)(344)(345)(346)(347).…”

Section: Role Of Onsite Cardiac Surgical Back-upmentioning

confidence: 99%

“…Any change in this recommendation awaits further data assessing the safety and outcomes for patients treated in various settings. (305,342). It has been argued that a well-planned strategy to provide rapid transfer to a surgical center in the event of a complication is tantamount to providing onsite surgical backup support.…”

Section: Role Of Low-volume Pci Programsmentioning

confidence: 99%

ACC/AHA/SCAI Practice Guidelines, February 21, 2006

Wilkins¹

2006

Circulation

348

View full text Add to dashboard Cite

“…With the advent of intracoronary stenting, there has been a decrease in the need for emergency coronary artery bypass, ranging between 0.4 and 2% 4,5 . Although the need for emergency bypass surgery has decreased very significantly due to the increased experience of the interventional cardiologists and due to the extensive use of coronary stents, serious and possible vital complications still may occur, frequently unexpected and sometimes during the treatment of non-complex and apparently easy to treat lesions.…”

Section: Surgical Back-upmentioning

confidence: 99%

Guidelines for percutaneous coronary intervention by the Belgian Working Group on Invasive Cardiology

Legrand¹,

Wijns²,

Vandenbranden³

et al. 2003

Acta Cardiologica

View full text Add to dashboard Cite

Urgent coronary bypass surgery for failed percutaneous coronary intervention in the stent era: Is backup still necessary?

Cited by 30 publications

References 17 publications

Emergency Coronary Artery Bypass Surgery in the Contemporary Percutaneous Coronary Intervention Era

Emergency Coronary Artery Bypass Surgery in the Contemporary Percutaneous Coronary Intervention Era

ACC/AHA/SCAI Practice Guidelines, February 21, 2006

Guidelines for percutaneous coronary intervention by the Belgian Working Group on Invasive Cardiology

Contact Info

Product

Resources

About