Document Detail


Aortocoronary bypass following unsuccessful PTCA: experience in 100 consecutive patients.
MedLine Citation:
PMID:  3160317     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
This study reviews the experience in a community hospital with aortocoronary bypass in 100 consecutive patients following failed percutaneous transluminal coronary angioplasty (PTCA) in terms of timing of intervention, morbidity, and mortality. Patients undergoing operation within 24 hours of PTCA are defined as the urgent group (68%) and those with intervention at greater than 24 hours, the elective group (32%). Mean interval from PTCA to operation was 43.5 days; among patients with apparently initially successful PTCA and hospital discharge, mean interval to operation was 138 days. Complete revascularization was carried out in all patients using standard techniques. Although the difference was not statistically significant, patients in the urgent group required intraaortic balloon pump support and inotropic infusions more often and experienced greater postoperative blood loss. Significant increases in the use of lidocaine and blood products were noted in the urgent group. The rates of major complications were 54.4% in the urgent group and 18.8% in the elective group. Mortality was 4.4% in the urgent group and 3.1% in the elective group (not significant); all deaths were cardiac related. There were no late deaths among survivors followed for 3 months to 4 years; 86% were in Functional Class I. We conclude that PTCA is a reasonable approach for some patients with ischemic heart disease. However, mandatory urgent aortocoronary bypass in these patients carries an increased morbidity and mortality, and patients should be selected with care.
Authors:
G J Brahos; N H Baker; H G Ewy; P J Moore; J W Thomas; P M Sanfelippo; R F McVicker; D J Fankhauser
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  40     ISSN:  0003-4975     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  1985 Jul 
Date Detail:
Created Date:  1985-08-12     Completed Date:  1985-08-12     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  7-10     Citation Subset:  AIM; IM    
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Angioplasty, Balloon / adverse effects*
Coronary Artery Bypass* / mortality
Coronary Disease / etiology,  surgery,  therapy*
Emergencies
Female
Follow-Up Studies
Humans
Male
Middle Aged
Postoperative Complications / etiology
Recurrence
Reoperation
Time Factors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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