SUMMARYThe results of percutaneous transluminal coronary angioplasty were studied in 1352 consecutive patients. The angioplasty procedure was angiographically successful in 1163 (86%) patients and the success rate increased gradually with time. There were no significant differences in success rates in different vessels or indications. The success rate for repeat coronary angioplasty was 92%. In 85% of the patients the clinical course was uncomplicated. Myocardial infarction occurred in 3-6%, emergency coronary bypass grafting in 2-6%, elective bypass surgery in 4 6% and there were 10 deaths (0 7 %).
Heparin levels were followed by an amidolytic method during open heart surgery in 10 adult patients and correlated to the activated clotting time (ACT) (Haemochron®). There was a good correlation between the 2 parameters when the ACT was below 600 s. Based on the present and previous studies of the ACT the authors conclude that the ACT is a useful tool in control of heparinization during open heart surgery.
The activated whole blood clotting time ( A m was analyzed in vitro using blood samples from normal individuals and from patients with heart disease, scheduled for open heart surgery. The ACT was found to be normally distributed in a group of normal individuals with a mean d 135 sec. In patients with heart diseases, the average ACT was slightly shorter than in normal individuals. A linear relationship between ACT and heparin concentrations was established. Haemdilution and depletion of platelets did not significantly influence the ACT. When a clean venipuncture with disposable needles is used, ACT is a reliable, uncomplicated bedside technique by which heparinisation can be monitored.
Heparin levels and ACT were followed during open heart surgery in lo patients. Heparin was assayed by an amidolytic method using substrate S-2222. ACT was determined with an automated method using celite and glass beads as activators of coagulation. Neither the hemodilution nor the depletion of platelets observed during extracorporeal circulation seemed to influence the ACT. An excellent correlation between the ACT and the actual heparin level was found in each patient with coefficients of correlation ranging from 0.73 – 0.97. A slightly better correlation was noticed for values of ACT below 600 seconds. It was concluded that the ACT is a valuable and reliable tool in control of heparinisation during open heart surgery.
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