Coronary artery bypass grafting within 30 days of an acute myocardial infarction

Risks and benefits of performing coronary artery bypass grafting (CABG) within 30 days of an acute myocardial infarction (AMI) were examined. In 642 patients operated on between January 1988 and December 1993, emergent CABG was performed in 46 patients for cardiogenic shock mainly for failed thrombolysis in patients with an evolving AMI. The remaining patients underwent urgent (72 hours) revascularization for failed percutaneous transluminal coronary angioplasty (n = 73), postinfarction angina (n = 381), vein graft stenosis (n = 100), and complications after an AMI (n = 42). In patients who underwent primary CABG for an uncomplicated AMI, the infarct was subendocardial in 68, anterolateral or septal in 200, inferior or posteroinferior in 200, and posterolateral in 32 patients. Early mortality (