Document Detail

Emergency cardiac procedures in patients in cardiogenic shock due to complications of coronary artery disease.
MedLine Citation:
PMID:  2655973     Owner:  NLM     Status:  MEDLINE    
Onset of cardiogenic shock in patients with various manifestations of acute myocardial ischemia has high mortality, but use of improved hemodynamic monitoring, the intra-aortic balloon pump, and early operation have improved previously dismal results. Review of published experience spanning the last 20 years indicates that 66% of patients survive after emergency myocardial revascularization for acute myocardial infarction and cardiogenic shock. If cardiac damage is overwhelming and irreversible, selected patients may be "bridged" with mechanical biventricular circulatory assist devices and transplanted. Infarctectomy for acute myocardial infarction remains controversial and unproven; successful repair of free left ventricular wall rupture is uncommon. In patients with cardiogenic shock, operations for acute postinfarction ventricular septal defect or mitral insufficiency have operative survival rates of 45% and 54%, respectively. Long-term (greater than 2-year) survival for patients after repair of acute postinfarction ventricular septal defect is 84%. However, 5-year survival after successful operation for acute postinfarction mitral insufficiency complicated by cardiogenic shock is only 40%.
H Bolooki
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Circulation     Volume:  79     ISSN:  0009-7322     ISO Abbreviation:  Circulation     Publication Date:  1989 Jun 
Date Detail:
Created Date:  1989-07-07     Completed Date:  1989-07-07     Revised Date:  2005-11-16    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  I137-48     Citation Subset:  AIM; IM    
University of Miami, Florida.
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MeSH Terms
Actuarial Analysis
Coronary Disease / complications*
Heart Valve Prosthesis*
Intra-Aortic Balloon Pumping*
Myocardial Revascularization* / mortality
Shock, Cardiogenic / etiology,  surgery*
Time Factors
Comment In:
Circulation. 1989 Jun;79(6 Pt 2):I149-51   [PMID:  2655974 ]
Circulation. 1989 Jun;79(6 Pt 2):I160-2   [PMID:  2720940 ]

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