| Risk analysis of operative intervention for failed coronary angioplasty. | |
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MedLine Citation:
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PMID: 1417279 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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To assess the outcome of emergency coronary artery bypass grafting (CABG) after failed percutaneous transluminal coronary angioplasty (PTCA), 91 patients undergoing emergency CABG after failed PTCA over a 30-month period ending July 31, 1991, were studied. For reference, a cohort of patients (91) concurrently undergoing elective CABG equally matched for age, sex, number of grafts, ventricular function, and reoperative status was compared. Specific outcomes including death, hospital length of stay, use of blood products, and development of myocardial infarction were analyzed. More than half the patients undergoing emergency CABG for failed PTCA required three or more grafts. Operative mortality was 12.1% (11/99) for emergency CABG compared with 1% (1/91) for elective case-matched CABG patients (p = 0.007). Emergency CABG patients required frequent use of postoperative inotropes (p = 0.02) and intraaortic balloon counterpulsation (p = 0.001). Length of hospital stay (p = 0.005), administration of blood products (p = 0.009), postoperative myocardial infarction (p = 0.0005), and ventricular arrhythmias (p = 0.0004) were increased after emergency compared with elective CABG. The presence of multivessel disease or use of a reperfusion catheter had no influence on clinical outcome. Despite accumulated experience and improved operative management, patients requiring emergency CABG for failed PTCA remain at increased risk for postoperative complications and death. |
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Authors:
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A M Borkon; T L Failing; J M Piehler; D A Killen; M L Hoskins; W A Reed |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: The Annals of thoracic surgery Volume: 54 ISSN: 0003-4975 ISO Abbreviation: Ann. Thorac. Surg. Publication Date: 1992 Nov |
Date Detail:
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Created Date: 1992-11-18 Completed Date: 1992-11-18 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 15030100R Medline TA: Ann Thorac Surg Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 884-90; discussion 890-1 Citation Subset: AIM; IM |
Affiliation:
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Mid America Heart Institute, St. Luke's Hospital, Kansas City, Missouri. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Angioplasty, Transluminal, Percutaneous Coronary*
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adverse effects Blood Transfusion Coronary Artery Bypass* / mortality Coronary Disease / surgery, therapy Emergencies Female Humans Intraoperative Complications Male Middle Aged Myocardial Infarction / etiology Postoperative Complications Risk Factors |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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