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Original article
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THE EFFECTIVENESS OF EMERGENCY CORONARY BYPASS SURGERY IN
ACUTE CORONARY SYNDROME
Yoqubov Asadbek Akhrorjon Ogli
Central Asian Medical University (CAMU), Faculty
of General Medicine, 2nd Year Student
Fergana City, Republic of Uzbekistan
Email: yoqubovasadbek838@gmail.com
Abstract:
This article discusses the effectiveness of emergency coronary artery bypass grafting
(CABG) in cases of acute coronary syndrome (ACS). Cardiovascular diseases are among the
leading causes of death in global healthcare systems. In ACS patients, restoring coronary blood
flow is vital. CABG is considered a highly effective approach in this regard. The article
examines the indications, benefits, and risk factors of CABG, analyzing success rates based on
modern scientific research.
Keywords:
Acute coronary syndrome, CABG, cardiovascular diseases, emergency surgery,
ischemia, myocardial infarction, bypass, cardiac surgery.
Introduction
Cardiovascular diseases are one of the primary causes of death worldwide. In particular, acute
coronary syndrome (ACS) poses a serious threat to patients' lives. In ACS, sudden blockage or
narrowing of coronary arteries causes a sharp decrease in oxygen supply to the heart muscle,
leading to ischemic injury. Timely emergency medical care can save the patient's life.
Emergency coronary artery bypass surgery (CABG) is highly effective in restoring blood flow to
the heart muscle, preventing myocardial infarction, and reducing heart failure. This article
scientifically analyzes the application, effectiveness, risk factors, and practical outcomes of
CABG in ACS.
How the Heart Functions During ACS
When ACS occurs, the heart does not beat normally. Due to lack of oxygen, the heart muscle
weakens and its contractile force decreases. This condition causes changes in heart rate—
tachycardia or bradycardia—and leads to arrhythmias such as fibrillation or extrasystole. ECG
changes include ST-segment elevation, T-wave inversion, and Q waves. Simply put, the heart
becomes unstable, weak, and beats in a dangerous rhythm.
Chapter 1: Etiology and Pathogenesis of Acute Coronary Syndrome
ACS is a condition characterized by the sudden onset of myocardial ischemia. It manifests in
three forms: unstable angina, ST-elevation myocardial infarction (STEMI), and non-ST-
elevation myocardial infarction (NSTEMI).
ISSN: 3030-3931, Impact factor: 7,241
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Etiological Factors:
Atherosclerosis – the main cause, forming plaques in coronary arteries.
Coagulation disorders – increase the risk of thrombus formation.
Risk factors: hypertension, diabetes, smoking, hyperlipidemia.
Pathogenesis: Plaque rupture → thrombus formation → blood flow blockage → myocardial
ischemia → necrosis (infarction).
Chapter 2: Clinical Signs and Diagnostic Methods
ACS symptoms often appear suddenly. The most common symptom is chest pain radiating to the
left arm, shoulder, neck, and jaw.
Diagnostic Methods:
ECG – distinguishes between STEMI and NSTEMI.
Troponin I/T, CK-MB – biochemical markers of cardiac injury.
Coronary angiography – accurately visualizes vessel condition.
Echocardiography – assesses cardiac contractile function.
Chapter 3: Coronary Artery Bypass Surgery (CABG)
CABG is a method of creating a 'bypass' route for blood to flow around blocked coronary
arteries. Grafts such as the saphenous vein or internal mammary artery are used. The surgery is
typically performed while the patient is on a heart-lung machine (cardioplegia).
Chapter 4: Emergency CABG in ACS Cases
Medication or percutaneous interventions (stents) are not always sufficient. CABG is urgently
performed in the following cases:
Left main coronary artery disease.
Multivessel coronary disease.
Failed stenting.
Hemodynamically unstable STEMI.
CABG improves blood flow, reduces infarct depth, and restores quality of life.
Chapter 5: Effectiveness of CABG – Based on Research
According to ESC (2023), 1-year survival after CABG is 92%, and 5-year survival is 84%.
Hannan et al. (2020) found a 40% reduction in infarction risk after CABG. Braunwald (2021)
reported significantly improved survival in ACS patients with heart failure undergoing CABG.
Chapter 6: Postoperative Care and Rehabilitation
Postoperative complications:
ISSN: 3030-3931, Impact factor: 7,241
Volume 8, issue2, Iyul 2025
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Bleeding
Cardiac arrhythmias
Infections
Graft failure (stenosis)
Rehabilitation:
Controlled physical activity
Medications: antiplatelets, beta-blockers
Healthy lifestyle
Conclusion and Recommendations
Emergency CABG is one of the most effective methods to save lives and restore heart function
in ACS. Timely surgery reduces infarct depth, lowers the risk of heart failure, and prolongs life
expectancy.
Recommendations: Develop emergency CABG protocols and expand cardiothoracic surgical
facilities in regional hospitals across the country.
References
1. Gadayev A.G. - Propaedeutics of Internal Diseases
2. Akhunov S.A. - Ischemic Heart Diseases and Diagnostic Foundations
3. Toraqulov J.M., Shumakov V.I. - Cardiology (Textbook)
4. Yusuf S. - Ischemic Heart Patients
5. Ministry of Health, Uzbekistan (2022) - Clinical Guidelines for Cardiovascular Diseases
6. Braunwald E. - Cardiovascular Medicine
7. ESC Task Force (2023) - Guidelines for ACS Management
8. Hannan E.L., Wu C. - Outcomes of CABG in Acute MI
9. Lancet - Effectiveness of CABG in ACS
10. WHO (2023) - Cardiovascular Factsheet
11. Bosceriya L.A. - Practical Approach from the American Heart Association
