Journal article
Aggressive Surgical Management of Post-Infarction Angina: Results of Myocardial Revascularization Early After Transmural Infarction
Texas Heart Institute journal, v 12(4), pp 333-337
01 Dec 1985
PMID: 15226989
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
In our Division of Cardiothoracic Surgery between 1970 and 1982, 110 patients (88 males and 22 females) had coronary artery bypass grafts (CABG) performed for unstable angina pectoris after acute transmural myocardial infarction. Fifty-one patients (mean age 59 years) had CABG within 2 weeks of myocardial infarction (Group 1); and 59 patients (mean age 56 years) (p = NS) within 6 weeks of myocardial infarction (Group 2). The incidence of preoperative arrhythmias, left ventricular ejection fraction, end-diastolic pressure, and the number of vessels diseased were similar in Groups 1 and 2. The incidence of cardiogenic shock was higher in Group 1 (16/51, 31% vs 2/59, 3% [p < 0.001]). This was also the case with the use of the intraaortic balloon (32/51, 63% vs 12/59, 20% [p < 0.001]), and the need for emergency operation (29/51, 57% vs 4/59, 7% [p < 0.001]). The mean number of grafts was 2.8 in Group 1 and 3.0 in Group 2 (p = NS).
Operative mortality was 20% (10/51) in Group 1 and 7% (4/59) in Group 2 (p < 0.01). Excluding patients in cardiogenic shock, operative mortality was 0% (0/35) in Group 1 and 5% (3/57) in Group 2 (p = NS). Incidences of late death, recurrent angina, and permanent disability were similar during mean follow-up times of 3.2 years in Group 1 and 4.1 years in Group 2. Actuarial probability of survival was 96% at 1 year and 83% at 5 years.
Myocardial revascularization early after transmural myocardial infarction has a low risk, especially in the absence of cardiogenic shock. These results justify an aggressive approach to unstable angina, including patients within 2 weeks of transmural infarction.
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Details
- Title
- Aggressive Surgical Management of Post-Infarction Angina: Results of Myocardial Revascularization Early After Transmural Infarction
- Creators
- Verdi J. Disesa - Brigham and Women's HospitalAnne C. O'Neil - Brigham and Women's HospitalDani Bitran - Brigham and Women's HospitalLawrence H. Cohn - Brigham and Women's HospitalRichard J. Shemin - Brigham and Women's HospitalJohn J. Collins - Brigham and Women's Hospital
- Publication Details
- Texas Heart Institute journal, v 12(4), pp 333-337
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- College of Medicine
- Web of Science ID
- WOS:A1985AWN5000009
- Other Identifier
- 991021463661304721
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- Web of Science research areas
- Cardiac & Cardiovascular Systems