Optimal bypass timing after an acute myocardial infarction

• Published in: The Thoracic and Cardiovascular Surgeon
• Main Authors: Kiessling, A, Isgro, F, Zahn, R, Weisse, U, Kammerer, I, Saggau, W
• Format: Conference Proceeding
• Language: German
• Published: 18.01.2005
• ISSN: 0171-6425; 1439-1902
• DOI: 10.1055/s-2005-861930

Objectives: Optimal timing for coronary artery bypass grafting (CABG) after acute myocardial infarction (AMI) remains controversial. The early CABG may result in reperfusion injury; a delay may risk a second ischemic event. Material and Methods: We retrospectively examined 5561 patients who underwent on pump CABG between 1993 and 2003, after an AMI (minimum 0 days, maximum 23 years). 5 subgroups were sub-divided for the time of surgical intervention. (I. 0–6 day, II. 7–13 day, III. 14–30 day, IV. 30–45 day, V. 45–60 day). Results: The inhospital mortality is significantly higher in the earliest intervention group. After a waiting period of 7 days, the survival rate is doubled. The demographic data and preoperative ejection fraction is similar in each subgroup. Conclusions: We conclude, that if ischemia or therapy resistant angina is not present after an AMI and clinical improvement is not increasing, the operative intervention should be done after a period of at least 7 days.