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| Predicate | Object |
|---|---|
| rdf:type | |
| lifeskim:mentions | |
| pubmed:issue |
5
|
| pubmed:dateCreated |
1992-7-30
|
| pubmed:abstractText |
Six hundred ninety-nine patients have required emergency coronary artery bypass after failed elective percutaneous coronary angioplasty during the decade September 1980 through December 1990. This represents 4% of 9860 patients having 12,146 elective percutaneous coronary angioplasty procedures during this interval. Emergency coronary artery bypass was required for acute refractory myocardial ischemia in 82%. Hospital mortality rate for all patients was 3.1%; 3.7% in patients with refractory myocardial ischemia but 0.8% in patients without refractory myocardial ischemia, p = 0.08. Postprocedural Q-wave myocardial infarctions were observed in 21% versus 2.4%, p less than 0.0001, and intra-aortic balloon pumping was required in 19% with versus 0.8% without refractory myocardial ischemia, p less than 0.0001. Multivessel disease, p = 0.004, age older than 65 years, p = 0.005, and refractory myocardial ischemia, p = 0.08, interacted to produce the highest risk of in-hospital death. Follow-up shows that there have been 28 additional late deaths, including 23 of cardiac causes for a 91% survival at 5 years. Freedom from both late death and Q-wave myocardial infarction at 5 years was 61%. In the group going to emergency coronary artery bypass with refractory myocardial ischemia, the late cardiac survival was 90%, and in those without ischemia, 92% at 5 years, p = not significant. The MI--free survival in the group with refractory ischemia, however, was 56% versus 83% in the group without ischemia, p less than 0.0001. Multivariate analysis showed the highest late event rates for patients with Q-wave myocardial infarction at the initial emergency coronary artery bypass, age older than 65 years, angina class III or IV, and prior coronary bypass surgery. In spite of a continuing high incidence of early acute myocardial infarction and an increasing operative mortality rate (7%) in the latest 3 years cohort of patients, excellent late survival and low subsequent cardiac event rates demonstrate the lasting effectiveness of prompt, successful emergency coronary bypass surgery for failed percutaneous coronary angioplasty.
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| pubmed:commentsCorrections |
http://linkedlifedata.com/resource/pubmed/commentcorrection/1616379-13655060,
http://linkedlifedata.com/resource/pubmed/commentcorrection/1616379-2229784,
http://linkedlifedata.com/resource/pubmed/commentcorrection/1616379-2295746,
http://linkedlifedata.com/resource/pubmed/commentcorrection/1616379-2321500,
http://linkedlifedata.com/resource/pubmed/commentcorrection/1616379-2401061,
http://linkedlifedata.com/resource/pubmed/commentcorrection/1616379-2401083,
http://linkedlifedata.com/resource/pubmed/commentcorrection/1616379-2422911,
http://linkedlifedata.com/resource/pubmed/commentcorrection/1616379-2932902,
http://linkedlifedata.com/resource/pubmed/commentcorrection/1616379-2938466,
http://linkedlifedata.com/resource/pubmed/commentcorrection/1616379-2962787,
http://linkedlifedata.com/resource/pubmed/commentcorrection/1616379-2969436,
http://linkedlifedata.com/resource/pubmed/commentcorrection/1616379-3161463,
http://linkedlifedata.com/resource/pubmed/commentcorrection/1616379-6213818,
http://linkedlifedata.com/resource/pubmed/commentcorrection/1616379-6215898
|
| pubmed:language |
eng
|
| pubmed:journal | |
| pubmed:citationSubset |
AIM
|
| pubmed:status |
MEDLINE
|
| pubmed:month |
May
|
| pubmed:issn |
0003-4932
|
| pubmed:author | |
| pubmed:issnType |
Print
|
| pubmed:volume |
215
|
| pubmed:owner |
NLM
|
| pubmed:authorsComplete |
Y
|
| pubmed:pagination |
425-33; discussion 433-4
|
| pubmed:dateRevised |
2010-11-18
|
| pubmed:meshHeading |
pubmed-meshheading:1616379-Actuarial Analysis,
pubmed-meshheading:1616379-Angioplasty, Balloon, Coronary,
pubmed-meshheading:1616379-Coronary Artery Bypass,
pubmed-meshheading:1616379-Coronary Disease,
pubmed-meshheading:1616379-Emergencies,
pubmed-meshheading:1616379-Female,
pubmed-meshheading:1616379-Follow-Up Studies,
pubmed-meshheading:1616379-Hospital Mortality,
pubmed-meshheading:1616379-Humans,
pubmed-meshheading:1616379-Incidence,
pubmed-meshheading:1616379-Intra-Aortic Balloon Pumping,
pubmed-meshheading:1616379-Male,
pubmed-meshheading:1616379-Middle Aged,
pubmed-meshheading:1616379-Myocardial Infarction,
pubmed-meshheading:1616379-Risk Factors,
pubmed-meshheading:1616379-Time Factors
|
| pubmed:year |
1992
|
| pubmed:articleTitle |
Emergency coronary artery bypass surgery for failed percutaneous coronary angioplasty. A 10-year experience.
|
| pubmed:affiliation |
Joseph B. Whitehead Department of Surgery, Emory University School of Medicine, Atlanta, Georgia.
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| pubmed:publicationType |
Journal Article
|