| Autor: |
Greene MA; Department of Surgery, University of Louisville School of Medicine, Kentucky 40202., Gray LA Jr, Slater AD, Ganzel BL, Mavroudis C |
| Jazyk: |
angličtina |
| Zdroj: |
The Annals of thoracic surgery [Ann Thorac Surg] 1991 Feb; Vol. 51 (2), pp. 194-9. |
| DOI: |
10.1016/0003-4975(91)90781-k |
| Abstrakt: |
One thousand two hundred fourteen percutaneous transluminal coronary angioplasties were performed over a 38-month period. Sixty patients required immediate emergency coronary artery bypass grafting after angioplasty failure; 7 of these had evidence of acute myocardial infarction before angioplasty and were excluded from the study. Of the 53 patients remaining, 27 (51%) had electrocardiographic and enzyme evidence of postoperative myocardial infarction. Two patients died (4%), and 10 had postoperative complications (19%). No statistical significance was noted comparing age, sex, incidence of prior myocardial infarction or myocardial dysfunction, time for revascularization, or average number of grafts completed in those with single-vessel (n = 21) versus multiple-vessel (n = 32) coronary artery disease. Postoperatively, those with multiple-vessel disease required intraaortic balloon pump support (p = 0.06) and antiarrhythmic medications more frequently than single-vessel patients (p less than 0.01) and had a higher complication rate (p less than 0.05). Although not reaching statistical significance, the data also suggest a higher death and postoperative myocardial infarction rate in patients with multiple-vessel disease. Emergency coronary artery bypass grafting after failed percutaneous transluminal coronary angioplasty carries a higher morbidity and mortality than elective coronary artery bypass grafting, particularly for patients with multiple-vessel coronary artery disease. |
| Databáze: |
MEDLINE |
| Externí odkaz: |
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