PURPOSE: Complications in CABG are not uncommon, but rarely reported and discussed. Also studies focusing on long term results or quality of life among patients surviving emergency reopening of the median sternotomy, open cardiac massage and further emergency cardiac surgery remain sparse.
METHODS: 1988-1999 a total of (76 0.9%) patients suffered sudden hemodynamic collapse following isolated CABG unrelated to pericardial tamponation or bleeding. Patients underwent emergency reopening and open cardiac massage with further emergency reoperation and additional grafting or graft repair in 57 (75%). Preoperatively matched patients from the same time period served as controls (n=76). In-hospital mortality of study patients was 46% (35). 41 study patients as well as all controls were discharged. In autumn 2009 all patients alive (26 study, 45 controls) were interviewed for quality of life using the Finnish version of RAND 36-Item Health Survey. Study patients and controls were compared using Mann-Whitney U test. Groups were separately compared to the Finnish reference population older than 65 years using One Sample t-test.
RESULTS: 19 (73%) (M/F=9/10) of 26 study patients and 31 (69%) (M/F=23/15) of 45 controls were available. Mean age was 7±09 and 72±7 years, respectively. The study patients and controls did not differ in general health, physical functioning, mental health, social functioning, vitality, bodily pain and physical or emotional role. In addition, neither group differed from the Finnish reference population older than 65 years.
CONCLUSION: CABG patients surviving hemodynamic collapse resulting in open cardiac massage and emergency cardiac reoperation achieve health related quality of life comparable to that of the normal population of same age group.
CLINICAL IMPLICATIONS: Resources focused on emergency procedures in those suffering severe hemodynamic collapse after coronary artery surgery result in survival in more than one half and in normal quality of life of the surviving patients.
DISCLOSURE: Ulla-Stina Salminen, No Financial Disclosure Information; No Product/Research Disclosure Information