نبذة مختصرة : In this study 57 patients undergoing emergency coronary artery bypass grafting by the department of cardiovascular surgery of the Aachen University were retrospectively analysed. By admission 28 patients (49%) had an acute myocardial infarction, the other 29 patients (51%) suffered from unstable angina. All in all 9 patients (16%) were in the state of cardiogenic shock, 4 of them (7%) were supported by intra-aortic balloon counterpulsation. 13 patients (23%) were operated immediately after PCI failure. The most frequent preoperative risk factors were arterial hypertension (86%), myocardial infarction (67%), hyperlipidemia (65%) and smoking (56%). In coronary angiography 70% of the patients had a triple-vessel disease, by 25% two vessels were concerned and only 5% had a one-vessel disease. Of the 57 patients 40 patients (70%) were operated by conventional coronary artery bypass grafting with cardioplegic arrest. 11 patients (19%) had an on-pump beating heart procedure and 6 patients (11%) were operated off-pump. In 77% an arterial graft was used. All in all every patient got on average 2,95 bypasses. In comparison the rates of complications were low. The most frequent seen complications were symptomatic transitory psychotic syndrome (25%), kidney failure (21%), revision (21%) and secondary haemorrhage (11%). Correspondingly the mortality was low in consideration of the severe situation of the patients. The operative mortality was 0%, the total mortality was 12,3%. For those who were hemodynamically unstable at the start of surgery the mortality was later 22%. Comparing these results with actual literature it could be shown that emergency operation was the right therapy for our patients because of their severe condition. In all cases they had the right indications for these procedures. They also got the treatment which promises the best prognostic results for such patients.
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