Document Detail


Surgical repair of remediable postinfarction cardiogenic shock in the elderly. Early and long-term results.
MedLine Citation:
PMID:  3958411     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The in-hospital mortality associated with acute myocardial infarction rises markedly with advancing age. It is not established whether the elderly may benefit from early surgical repair of postinfarction cardiogenic shock due to ventricular septal defect (VSD), acute severe mitral regurgitation (MR), or left ventricular power failure. Eighteen consecutive patients between the ages of 66 and 79 (mean, 72 years) and in cardiogenic shock underwent surgical repair, most with counterpulsation support, within one week of developing VSD, MR, or left ventricular power failure. Of ten patients with VSD, five (50%) survived. Three of seven patients with MR (43%) and the only patient with power failure survived for an overall survival of 50%. The nine long-term survivors were followed up for six months to five years (mean 31 months) by personal interviews with the patient or referring physician. There was one late death, due to congestive heart failure, ten months after the operation. Of the remaining eight patients, seven are categorized as New York Heart Association class I, and one as class II. These patients have all been able to live and function independently after cardiac operation. The authors conclude that older patients with postinfarction cardiogenic shock may benefit from early operation and that advanced age does not preclude successful surgical outcome. Furthermore, operation may result in excellent long-term quality of life.
Authors:
R M Weintraub; J Y Wei; R L Thurer
Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, Non-P.H.S.; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Journal of the American Geriatrics Society     Volume:  34     ISSN:  0002-8614     ISO Abbreviation:  J Am Geriatr Soc     Publication Date:  1986 May 
Date Detail:
Created Date:  1986-05-16     Completed Date:  1986-05-16     Revised Date:  2008-03-10    
Medline Journal Info:
Nlm Unique ID:  7503062     Medline TA:  J Am Geriatr Soc     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  389-92     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Aged
Female
Heart Failure / etiology,  mortality
Heart Rupture / etiology,  mortality,  surgery*
Heart Septum / surgery*
Hemodynamics
Humans
Intra-Aortic Balloon Pumping
Male
Mitral Valve Insufficiency / etiology,  mortality,  surgery*
Myocardial Infarction / complications*,  mortality,  physiopathology
Retrospective Studies
Shock, Cardiogenic / etiology*,  mortality,  physiopathology
Grant Support
ID/Acronym/Agency:
HL 29295/HL/NHLBI NIH HHS

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