| Acute myocardial infarction due to left main coronary artery occlusion. Therapeutic strategy. | |
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MedLine Citation:
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PMID: 11993195 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: Acute myocardial infarction due to left main coronary artery occlusion remains catastrophic and mostly fatal due to severe cardiogenic shock and arrhythmia. METHODS: We studied 13 patients undergoing coronary artery bypass grafting for acute myocardial infarction due to left main coronary artery occlusion to clarify the optimal management of these difficult patients. RESULTS: In-hospital mortality was 46.2% (6/13). Revascularization was achieved by catheter intervention followed by bypass surgery in 7, and bypass surgery alone in 6. Two bypass surgery patients without catheter intervention had collateral flow to the left coronary artery, with the right coronary artery dominant. The time from onset to recanalization in the survival group was significantly shorter than in the early death group. CONCLUSIONS: Emergency intervention to preserve left ventricular function or right coronary artery dominant and collateral blood flow to left coronary arteries is important for improving the prognosis of patients with acute myocardial infarction due to left main coronary artery occlusion. If residual left main coronary artery stenosis is significant or other proximal coronary stenosis exists after catheter intervention, early coronary bypass surgery may improve long-term survival. |
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Authors:
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Osamu Shigemitsu; Tetsuo Hadama; Shinji Miyamoto; Hirofumi Anai; Hidenori Sako; Eriko Iwata |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: The Japanese journal of thoracic and cardiovascular surgery : official publication of the Japanese Association for Thoracic Surgery = Nihon Kyōbu Geka Gakkai zasshi Volume: 50 ISSN: 1344-4964 ISO Abbreviation: Jpn. J. Thorac. Cardiovasc. Surg. Publication Date: 2002 Apr |
Date Detail:
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Created Date: 2002-05-07 Completed Date: 2002-05-17 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 100884261 Medline TA: Jpn J Thorac Cardiovasc Surg Country: Japan |
Other Details:
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Languages: eng Pagination: 146-51 Citation Subset: IM |
Affiliation:
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Department of Emergency Medicine, Oita Medical University, 1-1 Idaigaoka, Hasamamachi, Oita 879-5593, Japan. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Cardiopulmonary Bypass Coronary Artery Bypass* Coronary Disease / complications* Female Hospital Mortality Humans Male Middle Aged Myocardial Infarction / etiology*, mortality, surgery* Shock, Cardiogenic / etiology Survival Rate |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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