Document Detail


Angioplasty in severe heart attack. Anesthesia and general management.
MedLine Citation:
PMID:  12024081     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Percutaneous transluminal coronary angioplasty is more and more widely applied for the treatment of acute coronary syndromes. Both if primary employed or following an unsuccessful thrombolytic treatment (rescue angioplasty), it improves the early and late outcome of acute myocardial infarction patients. Anyway, in about 10% of the cases, it fails and must be followed by a coronary artery bypass graft operation. In this case, the patients reach the operating theater with a risk profile that differs from the usual one due to the higher rate of cardiogenic shock (4.5 vs 0.4%), need for intra-aortic balloon pumping (14 vs 0.8%), use of antiaggregants and heparin. METHODS: 3,296 patients who underwent coronary artery bypass graft operation over the last two years were analysed. RESULTS: Despite this, in our population of coronary patients undergone surgical revascularization (3,296 consecutive patients in the last two years), we could not find a worsened outcome in patients being operated after a failed primary percutaneous transluminal coronary angioplasty. CONCLUSIONS: The role of GPIIb-IIIa inhibitors in determining an excessive postoperative bleeding still remains to be defined, but probably mainly depends on the type of drug, its dose, and the time between its administration and the operation.
Authors:
M Ranucci
Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Minerva anestesiologica     Volume:  68     ISSN:  0375-9393     ISO Abbreviation:  Minerva Anestesiol     Publication Date:  2002 Apr 
Date Detail:
Created Date:  2002-05-23     Completed Date:  2002-09-03     Revised Date:  2005-11-16    
Medline Journal Info:
Nlm Unique ID:  0375272     Medline TA:  Minerva Anestesiol     Country:  Italy    
Other Details:
Languages:  eng     Pagination:  192-5     Citation Subset:  IM    
Affiliation:
Istituto Policlinico S. Donato, Department of Cardiothoracic Anesthesia, San Donato Milanese, Milan, Italy. cardioanestesia@virgilio.it
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MeSH Terms
Descriptor/Qualifier:
Acute Disease
Anesthesia*
Angioplasty, Transluminal, Percutaneous Coronary*
Coronary Artery Bypass
Coronary Disease / therapy*
Humans
Platelet Aggregation Inhibitors / therapeutic use
Risk Assessment
Treatment Failure
Treatment Outcome
Chemical
Reg. No./Substance:
0/Platelet Aggregation Inhibitors

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