AUTHOR=Mosorin Matti-Aleksi , Lantos Maté , Juvonen Tatu , Biancari Fausto 

TITLE=Five-Year Outcome after Coronary Artery Bypass Surgery in Survivors of Out-of-Hospital Cardiac Arrest

JOURNAL=Frontiers in Surgery

VOLUME=2

YEAR=2015

URL=https://www.frontiersin.org/journals/surgery/articles/10.3389/fsurg.2015.00002

DOI=10.3389/fsurg.2015.00002

ISSN=2296-875X

ABSTRACT=<p><bold>Objective:</bold> The aim of this study was to evaluate the role of coronary artery bypass grafting (CABG) in patients with out-of-hospital cardiac arrest (OHCA).</p><p><bold>Methods:</bold> The immediate and 5-year outcome after CABG of a consecutive series of 48 patients who survived OHCA was compared with those of control patients having had a recent myocardial infarction without ventricular arrhythmias.</p><p><bold>Results:</bold> All OHCA patients were found to have suffered myocardial infarction-related cardiac arrest. The mean delay from OHCA to CABG was 10.3 ± 13.0 days. Despite not statistically significant, the risk of 30-day postoperative mortality was higher among OHCA patients than control patients (6.3 vs. 0%, <italic>p</italic> = 0.24, propensity score adjusted analysis: <italic>p</italic> = 1.00). Cardioverter defibrillator was implanted in two patients who were alive 3.8 and 4.4 years after CABG, respectively. At 5-year, the overall survival rate was 80.7% in OHCA patients and 84.5% in control patients (<italic>p</italic> = 0.98, propensity score adjusted analysis: <italic>p</italic> = 0.87), and survival freedom from fatal cardiac event was 86.1% in OHCA patients and 86.5% in control patients (<italic>p</italic> = 0.61; propensity score adjusted analysis: <italic>p</italic> = 0.90).</p><p><bold>Conclusions:</bold> Early and 5-year survival rates after CABG in OHCA patients are excellent even when cardioverter defibrillator is very selectively implanted. The early and intermediate results CABG suggest a confident approach toward surgical revascularization in this critically ill patient population.</p>