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Ann Thorac Surg 1984;37:212-217
© 1984 The Society of Thoracic Surgeons

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Articles

Coronary Artery Bypass Surgery Following Thrombolytic Therapy for Acute Coronary Thrombosis

From the Departments of Cardiology, Deaconess Hospital and The Christ Hospital; the Departments of Cardiac Surgery, The Christ Hospital and Jewish Hospital; and the Division of Cardiothoracic Surgery, University of Cincinnati College of Medicine, Cincinnati, OH

^* Address reprint requests to Dr. Wilson, The Christ Hospital, Department of Cardiac Surgery, 2139 Auburn Ave, Cincinnati, OH 45219

One hundred thirty-six patients underwent thrombolytic therapy for acute evolving myocardial infarction from June, 1981, through December, 1982. Of these patients, 51 underwent coronary bypass procedures from two hours to 90 days (average, 16 days) following thrombolytic therapy. Six (12%) had single-vessel disease, 15 (29%) had double-vessel disease, and 30 (59%) had triple-vessel involvement. Ejection fraction values ranged from 21 to 60%. The average number of grafts performed per patient was 3.4.

There were no operative deaths in this series. Postoperative hemorrhagic problems were minimal, and the incidences were no different from those for other coronary bypass patients. In follow-up ranging from 2 to 18 months, there was no recurrence of severe angina or other clinical evidence of saphenous graft occlusion in the thrombolysed vessels. Of the 45 patients eligible to return to work, 40 (89%) have done so.

The data from this series suggest that surgical myocardial revascularization after intracoronary thrombolytic infusion for acute myocardial infarction can be performed safely and that complete recovery and a high return-to-work ratio can be anticipated.

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