| Late results after intracoronary thrombolysis and early bypass grafting for acute myocardial infarction. | |
| | |
MedLine Citation:
|
PMID: 2783469 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
Successful thrombolysis for acute myocardial infarction reduces early mortality. For definite correction of the underlying arteriosclerotic lesion, invasive treatment is mandatory. Early bypass grafting has been performed in 70 patients with an ischemic interval of less than 4 hours before reperfusion by thrombolysis. Surgery was undertaken an average of 4.5 days after the streptokinase administration. The hospital mortality rate was 1.4%. At 8 years the actuarial survival rate was 88% and the complication-free survival rate, 84%. At the latest follow-up study, 90% of the patients were in functional class I or II. Because of advanced age, 37% of the survivors have retired and 29% are working. Thirty-four percent did not return to work after the operation. In 24 patients a transmural needle biopsy specimen was taken at operation to study the extent of ischemic damage. Surprisingly, the extent of necrosis did not correlate with the ischemic interval (r = 0.17), whereas enzyme activity and extent of necrosis did correlate (r = 0.76). Late angiography was done in 44 patients (56%). The correlation between ischemic interval and regional wall motion score was weak when the whole group was considered (r = 0.35), but 70% of the patients with an ischemic interval of less than 3 hours had normal or near normal regional wall motion. In patients with prolonged ischemia, distribution between normal function and severe damage was uniform. In patients with ultrastructural and wall motion studies, early necrosis and late left ventricular function correlated fairly well (r = 0.69). We conclude that additional early bypass grafting after successful thrombolysis yields excellent long-term clinical results, especially in patients with an ischemic interval of less than 3 hours. |
| | |
Authors:
|
B J Messmer; R Uebis; C Rieger; C Minale; F Hofstădter; S Effert |
Related Documents
:
|
1901529 - Significance of a negative exercise thallium test in the presence of a critical residua... 11482859 - Improvement in decision-making for thrombolysis following introduction of angioplasty r... 6230919 - Improvement in regional and global left ventricular function after intracoronary thromb... 3100039 - Methodology and results of intravenous thrombolysis in acute myocardial infarction. 18772449 - Focal fluid-attenuated inversion recovery hyperintensity within acute diffusion-weighte... 12446059 - Relationship between baseline white blood cell count and degree of coronary artery dise... 6826949 - The high risk patient after recovery from myocardial infarction: recognition and manage... 21103749 - Is it time to adopt beating-heart coronary artery bypass grafting? a review of literature. 18941599 - Accessory mitral valve without left ventricular outflow tract obstruction in an adult. |
Publication Detail:
|
Type: Journal Article |
Journal Detail:
|
Title: The Journal of thoracic and cardiovascular surgery Volume: 97 ISSN: 0022-5223 ISO Abbreviation: J. Thorac. Cardiovasc. Surg. Publication Date: 1989 Jan |
Date Detail:
|
Created Date: 1989-02-10 Completed Date: 1989-02-10 Revised Date: 2004-11-17 |
Medline Journal Info:
|
Nlm Unique ID: 0376343 Medline TA: J Thorac Cardiovasc Surg Country: UNITED STATES |
Other Details:
|
Languages: eng Pagination: 10-8 Citation Subset: AIM; IM |
Affiliation:
|
Department of Thoracic and Cardiovascular Surgery, University Hospital, Aachen, Federal Republic of Germany. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Age Factors Coronary Artery Bypass* Coronary Disease / drug therapy* Coronary Thrombosis / drug therapy* Follow-Up Studies Humans Middle Aged Myocardial Infarction / drug therapy, mortality, surgery* Recurrence Reoperation Streptokinase / therapeutic use* Time Factors |
| Chemical | |
Reg. No./Substance:
|
EC 3.4.-/Streptokinase |
| Comments/Corrections | |
Comment In:
|
J Thorac Cardiovasc Surg. 1989 Dec;98(6):1145-6
[PMID:
2586135
]
|
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Differential effects of interleukin-1 and formylmethionylleucylphenylalanine on chemotaxis and human...
Next Document: Effects of hypothermia and hemodilution on oxygen metabolism and hemodynamics in patients recovering...