On-pump beating heart coronary revascularization: Is it valid for emergency revascularization?

Background: On-pump beating heart coronary artery bypass grafting (CABG) may be considered as an alternative to the conventional on-pump surgery in patients presenting with acute coronary syndrome requiring emergency revascularization. This study reports our clinical experience and early outcomes with the on-pump beating heart coronary surgery on patients with acute coronary syndrome. Design and Settings: A retrospective study conducted from August 2009 to October, 2015, in a regional training and research hospital in Turkey. Methods: A total of 1432 patients underwent isolated CABG at our institution. A total of 316 of these patients underwent the on-pump beating heart procedure without cardioplegic arrest by the same surgeon. Results: The time interval from the onset of acute myocardial infarction to CABG was 10 (2.2) hours. The mean number of grafts was 3.0 (0.6). Hospital mortality was 2.9% (9 patients). Twelve patients had low cardiac output syndromes after surgery. Eight of them had renal dysfunction but none of them needed hemodialysis. The mean intensive care unit stay was 3 (2) days and the mean hospital length of stay was 7 (4) days. Conclusion: We think that the on-pump beating heart revascularization technique can be a good choice for emergency CABG of high-risk patients with a multivessel coronary artery disease.