Document Detail


Factors influencing mortality after emergency coronary artery bypass grafting for failed percutaneous transluminal coronary angioplasty.
MedLine Citation:
PMID:  9436566     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Emergency coronary artery bypass grafting after failed percutaneous transluminal coronary angioplasty is associated with increased mortality. METHODS: From 1981 through 1995, 117 patients at our institution underwent emergency coronary artery bypass grafting after failed percutaneous transluminal coronary angioplasty, with an in-hospital mortality rate of 13.6%. Univariate and multivariate analyses were used to identify the factors that influenced the risk of death. RESULTS: Univariate analysis revealed that patients who died more often were women and had chronic renal failure, lower ejection fractions, and more diffuse coronary artery disease; less often received an internal mammary artery graft or an antegrade perfusion catheter; required inotropic support in the cardiac catheterization laboratory; and experienced myocardial infarction. Multivariate analysis demonstrated that the need for inotropic support in the cardiac catheterization laboratory was the best predictor of perioperative death. CONCLUSIONS: Patients with a reduced ejection fraction in whom percutaneous transluminal coronary angioplasty fails, antegrade perfusion does not produce a response, and myocardial infarction occurs are more likely to die after coronary artery bypass grafting. The risk appears to be highest for patients who require inotropic support in the cardiac catheterization laboratory.
Authors:
H L Lazar; A K Jacobs; G S Aldea; O M Shapira; D Lancaster; R J Shemin
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  64     ISSN:  0003-4975     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  1997 Dec 
Date Detail:
Created Date:  1998-02-10     Completed Date:  1998-02-10     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:  1747-52     Citation Subset:  AIM; IM    
Affiliation:
Department of Cardiothoracic Surgery, The Boston Medical Center, Massachusetts 02118, USA.
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MeSH Terms
Descriptor/Qualifier:
Analysis of Variance
Angioplasty, Transluminal, Percutaneous Coronary*
Cardiotonic Agents / therapeutic use
Coronary Artery Bypass / mortality*
Coronary Disease / pathology
Emergencies
Female
Heart Catheterization
Humans
Kidney Failure, Chronic / complications
Male
Middle Aged
Sex Factors
Stroke Volume
Treatment Outcome
Chemical
Reg. No./Substance:
0/Cardiotonic Agents

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


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