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The Annals of Thoracic Surgery, Vol 43, 131-137, Copyright © 1987 by The Society of Thoracic Surgeons
CW Akins
From January, 1982, through November, 1985, 127 consecutive patients had
emergency isolated myocardial revascularization during hypothermic
fibrillatory arrest. Mean age was 62.3 years; 27 patients (21.2%) were
older than 70 years. Mean ejection fraction was 0.49, with 20 (15.7%) less
than 0.35. Intraaortic balloons were present in 109 patients (85.8%).
Nitroglycerin was given intravenously to 97 patients (76.3%), and
thrombolytic therapy had been used in 12 patients (9.4%). Indications for
operation were postinfarction ischemia in 61 patients (48.0%),
preinfarction unstable angina in 44 (34.6%), acute ischemia following
failed percutaneous angioplasty in 14 (11.0%), and cardiogenic shock in 8
(6.3%). Operation was performed within 1 week of an acute infarction in 47
patients. Mean number of grafts per patient was 4.1. There was 1 hospital
death (0.8%) and 1 perioperative myocardial infarction (0.8%). Actuarial
survival at 45 months was 90.8 +/- 2.9%. Mean New York Heart Association
Classification for the 117 long-term survivors was 1.12.
ARTICLES
Early and late results following emergency isolated myocardial revascularization during hypothermic fibrillatory arrest
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