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The Annals of Thoracic Surgery, Vol 38, 265-267, Copyright © 1984 by The Society of Thoracic Surgeons
WA Baumgartner, AM Borkon, J Zibulewsky, L Watkins Jr, TJ Gardner, BH Bulkley, SC Achuff, KL Baughman, TA Traill and VL Gott
Thirty-four patients (26 men and 8 women) underwent myocardial
revascularization following myocardial infarction (MI) at the Johns Hopkins
Hospital during 1980 through 1982. Average age was 59 years. Of the 33
patients with unstable angina, 61% had ischemia in the infarct zone and 39%
had "ischemia at a distance." Mean time from MI to operation was 16 days.
The MIs were equally divided between a transmural and a subendocardial
location. Eleven patients had a history of congestive heart failure.
Intraaortic balloon pumping was used preoperatively for anginal
stabilization in 14 patients. Mean ejection fraction for the group was 52%.
There were 3 operative deaths, all 3 due to myocardial failure. Late
follow-up (mean, 13.7 months; range, 6 to 35 months) is complete for 28
patients. There was 1 late death, secondary to cardiac failure. There were
no late MIs. Angina had recurred in 5 patients, but only 2 were taking
antianginal medication. At the time of follow-up, 52% of patients were in
New York Heart Association Functional Class I. This experience suggests
that operative intervention for postinfarction angina can be accomplished
with an acceptable mortality and thereby increase survival, reduce the
later occurrence of MI, and relieve angina in this high-risk group.
ARTICLES
Operative intervention for postinfarction angina
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