HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Phillips, S. J. Articles by Kongtahworn, C. Search for Related Content PubMed PubMed Citation Articles by Phillips, S. J. Articles by Kongtahworn, C.

The Annals of Thoracic Surgery, Vol 41, 119-125, Copyright © 1986 by The Society of Thoracic Surgeons

ARTICLES

Reperfusion protocol and results in 738 patients with evolving myocardial infarction

SJ Phillips, RH Zeff, JR Skinner, RS Toon, A Grignon and C Kongtahworn

Reperfusion is an accepted therapy for evolving myocardial infarction (MI), as successful reperfusion reduces morbidity and mortality. A team approach between the cardiologists and cardiac surgeons must be applied to achieve reperfusion within a finite time from the onset of coronary thrombosis. Analysis of 738 patients grouped them by successful reperfusion in the catheterization laboratory versus the operating room. Factors that predict wall motion recovery related to the onset of clinical symptoms, time to reperfusion, coronary anatomy, and collateral network were reviewed. Comparisons were made between patients with stable versus unstable hemodynamics and successful or unsuccessful reperfusion. Of the 738 patients, the initial attempt at reperfusion was made in the catheterization laboratory with success in 331. These patients all had primarily single-vessel disease. With multiple-vessel disease identified at catheterization, 189 patients were immediately treated by surgical reperfusion. This method also was used for an additional 72 patients in whom reperfusion could not be achieved in the catheterization laboratory. Of the entire group of 738 patients, 146 (20%) could not be reperfused. Overall mortality for the 592 patients reperfused was 4.9% compared with 17% for those who could not be reperfused. Time was critical for wall motion recovery if no collaterals were demonstrated on angiography. If collaterals were present, time to reperfusion was not critical. Wall motion recovered in 90% of the patients if the endocardial anatomy on the initial angiogram was smooth. However, if the endocardial anatomy looked mottled and irregular, less than 10% of patients had recovery of wall motion.(ABSTRACT TRUNCATED AT 250 WORDS)

This article has been cited by other articles:

				I. George and M. C. Oz Myocardial Revascularization after Acute Myocardial Infarction Card. Surg. Adult, January 1, 2008; 3(2008): 669 - 696. [Full Text]

				D. C. Lee, W. Ting, and M. C. Oz Myocardial Revascularization after Acute Myocardial Infarction Card. Surg. Adult, January 1, 2003; 2(2003): 639 - 658. [Full Text]

				J. S. Hochman, C. E. Buller, L. A. Sleeper, J. Boland, V. Dzavik, T. A. Sanborn, E. Godfrey, H. D. White, J. Lim, T. LeJemtel, et al. Cardiogenic shock complicating acute myocardial infarction--etiologies, management and outcome: a report from the SHOCK Trial Registry J. Am. Coll. Cardiol., September 1, 2000; 36(3_Suppl_A): 1063 - 1070. [Abstract] [Full Text] [PDF]

				T. A. Sanborn, L. A. Sleeper, E. R. Bates, A. K. Jacobs, J. Boland, J. K. French, J. Dens, V. Dzavik, S. T. Palmeri, J. G. Webb, et al. Impact of thrombolysis, intra-aortic balloon pump counterpulsation, and their combination in cardiogenic shock complicating acute myocardial infarction: a report from the SHOCK Trial Registry J. Am. Coll. Cardiol., September 1, 2000; 36(3_Suppl_A): 1123 - 1129. [Abstract] [Full Text] [PDF]

				S G Williams, D J Wright, and L B Tan Management of cardiogenic shock complicating acute myocardial infarction: towards evidence based medical practice Heart, June 1, 2000; 83(6): 621 - 626. [Full Text]

				B. Tomasco, A. Cappiello, R. Fiorilli, A. Leccese, R. Lupino, A. Romiti, and U. F. Tesler Surgical Revascularization for Acute Coronary Insufficiency: Analysis of Risk Factors for Hospital Mortality Ann. Thorac. Surg., September 1, 1997; 64(3): 678 - 683. [Abstract] [Full Text]