Coronary artery bypass surgery after failed PCI
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Coronary Artery Bypass Surgery Microchapters | |
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Pathophysiology | |
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Diagnosis | |
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Perioperative Monitoring | |
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Coronary artery bypass surgery after failed PCI On the Web | |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Varun Kumar, M.B.B.S. [2]
Overview
Stenting has dramatically increased the safety of PCI. Data from 23,087 Mayo Clinic patients who had a PCI from 1979 to 2003 was analyzed, and it was found that though there has been an increase in high-risk patients undergoing PCI, there has been a decrease in the incidence of patients requiring emergency CABG in the current stent era (2000-2003, n= 6,577). The in-patient mortality rate for those requiring emergency CABG remains unchanged.[1]
2011 ACCF/AHA Guideline for Coronary Artery Bypass Graft Surgery (DO NOT EDIT)[2]
Emergency CABG After Failed PCI (DO NOT EDIT)[2]
| Class I |
| "1. Emergency CABG is recommended after failed PCI in the presence of ongoing ischemia or threatened occlusion with substantial myocardium at risk.[3][4] (Level of Evidence: B)" |
| "2. Emergency CABG is recommended after failed PCI for hemodynamic compromise in patients without impairment of the coagulation system and without a previous sternotomy.[3][5][6] (Level of Evidence: B)" |
| Class III: HARM |
| "1. Emergency CABG should not be performed after failed PCI in the absence of ischemia or threatened occlusion. (Level of Evidence: C)" |
| "2. Emergency CABG should not be performed after failed PCI if revascularization is impossible because of target anatomy or a no-reflow state. (Level of Evidence: C)" |
| Class IIa |
| "1. Emergency CABG is reasonable after failed PCI for retrieval of a foreign body (most likely a fractured guidewire or stent) in a crucial anatomic location. (Level of Evidence: C)" |
| "2. Emergency CABG can be beneficial after failed PCI for hemodynamic compromise in patients with impairment of the coagulation system and without previous sternotomy. (Level of Evidence: C)" |
| Class IIb |
| "1. Emergency CABG might be considered after failed PCI for hemodynamic compromise in patients with previous sternotomy. (Level of Evidence: C)" |
References
- ↑ Yang EH, Gumina RJ, Lennon RJ, Holmes DR, Rihal CS, Singh M (2005). "Emergency coronary artery bypass surgery for percutaneous coronary interventions: changes in the incidence, clinical characteristics, and indications from 1979 to 2003". J Am Coll Cardiol. 46 (11): 2004–9. doi:10.1016/j.jacc.2005.06.083. PMID 16325032.
- ↑ 2.0 2.1 Hillis LD, Smith PK, Anderson JL, Bittl JA, Bridges CR, Byrne JG; et al. (2011). "2011 ACCF/AHA Guideline for Coronary Artery Bypass Graft Surgery: A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines". Circulation. doi:10.1161/CIR.0b013e31823c074e. PMID 22064599.
- ↑ 3.0 3.1 Barakate MS, Bannon PG, Hughes CF, Horton MD, Callaway A, Hurst T (2003). "Emergency surgery after unsuccessful coronary angioplasty: a review of 15 years' experience". The Annals of Thoracic Surgery. 75 (5): 1400–5. PMID 12735553. Unknown parameter
|month=ignored (help);|access-date=requires|url=(help) - ↑ Roy P, de Labriolle A, Hanna N, Bonello L, Okabe T, Pinto Slottow TL, Steinberg DH, Torguson R, Kaneshige K, Xue Z, Satler LF, Kent KM, Suddath WO, Pichard AD, Lindsay J, Waksman R (2009). "Requirement for emergent coronary artery bypass surgery following percutaneous coronary intervention in the stent era". The American Journal of Cardiology. 103 (7): 950–3. doi:10.1016/j.amjcard.2008.12.025. PMID 19327421. Retrieved 2011-12-10. Unknown parameter
|month=ignored (help) - ↑ Craver JM, Weintraub WS, Jones EL, Guyton RA, Hatcher CR (1992). "Emergency coronary artery bypass surgery for failed percutaneous coronary angioplasty. A 10-year experience". Annals of Surgery. 215 (5): 425–33, discussion 433–4. PMC 1242467. PMID 1616379. Unknown parameter
|month=ignored (help);|access-date=requires|url=(help) - ↑ Stamou SC, Hill PC, Haile E, Prince S, Mack MJ, Corso PJ (2006). "Clinical outcomes of nonelective coronary revascularization with and without cardiopulmonary bypass". The Journal of Thoracic and Cardiovascular Surgery. 131 (1): 28–33. doi:10.1016/j.jtcvs.2005.08.059. PMID 16399291. Retrieved 2011-12-10. Unknown parameter
|month=ignored (help)