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Ann Thorac Surg 1987;43:131-137
© 1987 The Society of Thoracic Surgeons

Articles

Early and Late Results Following Emergency Isolated Myocardial Revascularization During Hypothermic Fibrillatory Arrest

Cary W. Akins, M.D.*

From the Cardiac Surgical Unit, Massachusetts General Hospital, Boston, MA

Accepted for publication March 10, 1986.

* Address reprint requests to Dr. Akins, Department of Surgery, Massachusetts General Hospital, Boston, MA 02114

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.




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