Document Detail


Results of coronary surgery after failed elective coronary angioplasty in patients with prior coronary surgery.
MedLine Citation:
PMID:  2229784     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The results of coronary artery bypass surgery after failed elective coronary angioplasty in patients who have undergone prior coronary surgery are unknown. Coronary angioplasty may be performed to relieve angina after surgery either to the native coronary vessels or to grafts. Failure of attempted coronary angioplasty may mandate repeat coronary surgery, often in the setting of acute ischemia. From 1980 to 1989, 1,263 patients with prior coronary bypass surgery underwent angioplasty; of these patients, 46 (3.6%) underwent reoperation for failed angioplasty during the same hospital stay. Of the 46 patients who underwent reoperation, 33 had and 13 did not have acute ischemia. In the group with ischemia, 3 patients (9.1%) died and 14 (42.4%) died or had a Q wave myocardial infarction in the hospital compared with no deaths (p = NS) and no deaths or Q wave myocardial infarction (p = 0.005) in the group without ischemia. At 3 years, the actuarial survival rate was 88 +/- 6% in the group with ischemia, whereas there were no deaths in the group without ischemia (p = NS), and freedom from death or myocardial infarction was 51 +/- 10% in the group with ischemia, versus no events in the group without ischemia (p = 0.006). In most patients with prior coronary bypass surgery, coronary angioplasty was performed without the need for repeat coronary bypass surgery. Should coronary angioplasty fail, reoperation in patients without acute ischemia can be performed with overall patient survival comparable to that of elective reoperative coronary bypass without coronary angioplasty.(ABSTRACT TRUNCATED AT 250 WORDS)
Authors:
W S Weintraub; C L Cohen; P E Curling; E L Jones; J M Craver; R Guyton; S B King; J S Douglas
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of the American College of Cardiology     Volume:  16     ISSN:  0735-1097     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  1990 Nov 
Date Detail:
Created Date:  1990-12-27     Completed Date:  1990-12-27     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1341-7     Citation Subset:  AIM; IM    
Affiliation:
Division of Cardiology, Emory University School of Medicine, Atlanta, Georgia.
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MeSH Terms
Descriptor/Qualifier:
Aged
Angioplasty, Transluminal, Percutaneous Coronary*
Combined Modality Therapy
Coronary Artery Bypass* / mortality
Coronary Disease / mortality,  physiopathology,  therapy*
Electrocardiography
Emergencies
Female
Follow-Up Studies
Humans
Length of Stay
Male
Middle Aged
Prospective Studies
Recurrence
Survival Rate
Comments/Corrections
Comment In:
J Am Coll Cardiol. 1990 Nov;16(6):1348-50   [PMID:  2229785 ]

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


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