| Coronary artery bypass without cardiopulmonary bypass for patients with acute myocardial infarction. | |
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MedLine Citation:
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PMID: 10384184 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: Between January 1992 and December 1994, 57 patients having an acute myocardial infarction with coronary anatomy suitable for coronary artery bypass grafting without cardiopulmonary bypass underwent this procedure within 1 week of the infarction. We describe the surgical results of these high-risk patients. METHODS: The study population included 43 male patients (75%) and 14 female patients (25%) whose mean age was 58.5 +/- 10.4 years. Thirty-two patients (56%) underwent emergency bypass grafting within 48 hours of an acute myocardial infarction, 4 of them (12.5%) as a bailout procedure after complicated percutaneous transluminal coronary angioplasty. Of these 32 patients, 7 patients (22%) were in cardiogenic shock, and 10 patients (31%) required preoperative intra-aortic balloon pump. Twenty-five patients (44%) underwent coronary bypass grafting 2 to 7 days after an acute myocardial infarction. The mean number of grafts per patient was 1.8 (range, 1-4), and the internal thoracic artery was used in 47 patients (82%). Only 7 patients (12%) received grafts to a circumflex marginal branch. RESULTS: Operative mortality was 1.7% (1 patient), and the mean postoperative hospital stay was 6.8 +/- 3 days. One- and 5-year actuarial survivals were 94.7% and 82.3%, respectively. Angina returned in 7 patients (12%), 1 of whom underwent reoperation. Multivariate analysis revealed renal failure and preoperative cardiogenic shock to be independent predictors of overall mortality. Old myocardial infarction and operation within the first 48 hours were independent predictors of overall unfavorable outcome events. CONCLUSIONS: These results suggest that coronary artery bypass grafting without cardiopulmonary bypass is a relatively low-risk procedure for patients having an infarction with coronary anatomy suitable for this technique. |
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Authors:
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R Mohr; Y Moshkovitch; I Shapira; G Amir; H Hod; J Gurevitch |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: The Journal of thoracic and cardiovascular surgery Volume: 118 ISSN: 0022-5223 ISO Abbreviation: J. Thorac. Cardiovasc. Surg. Publication Date: 1999 Jul |
Date Detail:
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Created Date: 1999-07-22 Completed Date: 1999-07-22 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 0376343 Medline TA: J Thorac Cardiovasc Surg Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 50-6 Citation Subset: AIM; IM |
Affiliation:
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Department of Thoracic and Cardiovascular Surgery, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Actuarial Analysis Aged Angioplasty, Transluminal, Percutaneous Coronary Cardiopulmonary Bypass* Coronary Artery Bypass / methods*, mortality Female Follow-Up Studies Humans Intra-Aortic Balloon Pumping Kidney Failure / etiology Length of Stay / statistics & numerical data Male Middle Aged Multivariate Analysis Myocardial Infarction / complications, mortality, surgery* Predictive Value of Tests Risk Factors Shock, Cardiogenic / etiology Survival Analysis Time Factors Treatment Outcome |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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