Surgical revascularization in acute myocardial infarction

Details

Serval ID
serval:BIB_4FD7C1C1A989
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Surgical revascularization in acute myocardial infarction
Journal
European Journal of Cardio-Thoracic Surgery
Author(s)
von Segesser  L. K., Popp  J., Amann  F. W., Turina  M. I.
ISSN
1010-7940
Publication state
Published
Issued date
1994
Peer-reviewed
Oui
Volume
8
Number
7
Pages
363-8; discussion 368-9
Notes
Journal Article
Abstract
To determine the potential benefit of myocardial revascularizations in acute myocardial infarction we analyzed a consecutive series of 641/3397 patients with stable or unstable angina in Canadian Heart Association Class IV divided into five groups: A) unstable angina (ECG S-T modifications), B) evolving infarction (new Q-wave, CK more than 3 times normal), C) mechanical complications (ventricular septal defect (VSD), wall rupture, acute mitral regurgitation), D) coronary artery occlusion (crashed percutaneous transluminal coronary angioplasty (PTCA)), and E) stable angina class IV (control group). The mean follow-up was 72 +/- 33 months (range 24-144 months). Of the 641 patients 362 were unstable (A), 22 had evolving infarction (B), 20 suffered from mechanical complications (C), 48 had acute coronary artery occlusion (D), and 189 were in the control group (E). There was no difference for left ventricular (LV) ejection fraction before surgery (P < 0.05 = * as compared to control (E)), however cardiogenic shock was present before surgery in 13/362 (4%) for unstable angina, 5/22 (23%) for evolving infarction, 6/20 (30%) for mechanical complications, 4/48 (8%) for acute occlusion, and none of the controls. The number of bypasses was 3.8 +/- 1.3* for unstable angina, 3.6 +/- 1.3 for evolving infarction, 2.3 +/- 1.2* for mechanical complications, 2.0 +/- 1.2* for acute occlusion, and 3.4 +/- 1.5 for control. Intra-aortic balloon pumping was necessary in 26/362 (7%) for unstable angina, 5/22 (23%*) for evolving infarction, 7/20 (35%*) for mechanical complications, 7/48 (15%*) for acute occlusions, and 5/189 (3%) of the controls.(ABSTRACT TRUNCATED AT 250 WORDS)
Keywords
Adult Aged Aged, 80 and over Angina, Unstable/surgery *Coronary Artery Bypass Coronary Disease/surgery Female Humans Life Tables Longitudinal Studies Male Middle Aged Myocardial Infarction/surgery Myocardial Ischemia/mortality/*surgery Survival Rate
Pubmed
Web of science
Create date
14/02/2008 14:17
Last modification date
20/08/2019 14:05
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