Coronary Bypass for Relief of Persistent Pain Following Acute Myocardial Infarction

Jones, Ellis L.; Waites, Thad F.; Craver, Joseph M.; Bradford, James M.; Douglas, John S.; King, Spencer B.; Bone, David K.; Dorney, Edward R.; Clements, Stephen D.; Thompkins, Tom; Hatcher, Charles R.

doi:10.1016/s0003-4975(10)61371-9

Cited by 60 publications

(8 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Of these, 101 patients had postinfarction unstable angina and fulfilled the following criteria: (1) chest pain at rest, lasting for at (27) 5 (9) 0 (0) 21 (40) 21 (40) 4 (8) 5 (9) 1 (1) 1 (1) Bypass surgery 48 3 (6) 6 (13) 34 (71) 5 (10) 13 (27) 10 (21) 13 (27) Selective coronary angiography was performed in multiple projections, including hemiaxial views. A lesion with a luminal diameter stenosis of more than 50% was considered hemodynamically significant.…”

Section: Methodsmentioning

confidence: 99%

“…To exclude or prevent coronary spasm, nifedipine or nitroglycerin was infused into the coronary artery and this was repeated when necessary. 8 Initial balloon inflation pressure was 2.0 atm, with subsequent inflations ranging to 12 atm. The number of balloon inflations varied depending on the appearance of the lesion as seen during immediate postdilatation angiography and on the residual gradient across the stenosis.…”

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Coronary angioplasty for early postinfarction unstable angina.

Feyter¹,

Serruys²,

Soward³

et al. 1986

Circulation

View full text Add to dashboard Cite

Coronary angioplasty was performed in 53 patients in whom unstable angina had reoccurred after 48 hr and within 30 days after sustained myocardial infarction. Single-vessel disease was present in 64% of the patients and multivessel disease in 36%. The preceding myocardial infarction had been small to moderate in size in the majority of the patients. The left ventricular ejection fraction was more than 50% in 80% of the patients. Forty-five patients were refractory to pharmacologic treatment; eight were initially stabilized but once again became symptomatic with light exertion. Angioplasty was performed in 35 patients 2 to 14 days and in 18 patients 15 to 30 days after infarction (average 12 + 7 days after infarction). The initial success rate was 89% (47/53). The success rate of the patients treated at 2 to 14 days was lower (29/35, 83%) than that of patients treated at 14 to 30 days (18/18, 100%) but did not reach statistical significance (p < .06). There were no deaths related to the procedure. In four of the six failures, emergency bypass surgery was performed and two patients sustained a myocardial infarction. Furthermore, a myocardial infarction complicated the angioplasty procedure in two other patients; thus the overall procedure-related myocardial infarction rate was 8% (4/53). At 6 months follow-up, 26% (14/53) of all the patients who underwent angioplasty had recurrence of angina, which was successfully treated with repeat angioplasty, bypass surgery, or medical therapy. There were no late deaths. Late myocardial infarction occurred in two patients. Thus the total myocardial infarction rate after angioplasty at 6 months was 1 1% (6/53 patients). In 42 of the 47 (89%) patients with successful angioplasty, angiography was repeated a mean 3.3 ± 2.5 months after angioplasty. The angiographic restenosis rate was 33%. We conclude that in selected patients, coronary angioplasty for unstable angina occurring 48 hr to 30 days after a myocardial infarction is an effective treatment with an acceptable risk, a high initial success rate, and a sustained beneficial effect. Circulation 74, No. 6, [1365][1366][1367][1368][1369][1370] 1986 THE PRESENCE of ischemic yet viable myocardium in a patient with angina early after an infarction places that patient at increased risk of reinfarction,'-which carries a poor short-and long-term prognosis. In this study we report our experience with coronary angioplasty in the treatment of patients with unstable angina occurring after 48 hr and within 30 days after myocardial infarction.

show abstract

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Coronary angioplasty for early postinfarction unstable angina.

Feyter¹,

Serruys²,

Soward³

et al. 1986

Circulation

View full text Add to dashboard Cite

show abstract

“…Recent reports [34][35][36][37][38][39] have suggested that myocardial revascularization within the first 30 days after myocardial infarction can be accomplished with an acceptable operative mortality in selected patients, although overall mortality and morbidity rates are higher than those reported for elective surgery. Accordingly, current strategy for the management of patients with early postinfarction angina is aimed at delaying surgery until such a time when it can be performed with less inherent risks.…”

Section: Coronary Angioplasty For Early Postinfarction Anginamentioning

confidence: 99%

Indications for coronary angioplasty in acute myocardial ischemic syndromes

Feyter

Serruys

Hugenholtz

1988

Cardiovasc Drug Ther

View full text Add to dashboard Cite

The role of coronary angioplasty for the treatment of patients with evolving myocardial infarction, unstable angina, and early postinfarction unstable angina is discussed. It has been shown that coronary angioplasty in patients with an evolving myocardial infarction is feasible and can be performed with a high initial success rate. The most beneficial timing of dilatation is still unclear, and acute reocclusion following coronary angioplasty remains a problem. Current data suggest that the left ventricular function is greater improved and peri-infarction ischemia is less with angioplasty when compared with sole thrombolytic treatment. Coronary angioplasty for unstable angina and early post-infarction unstable angina can be performed with a high initial success rate, but at an increased risk of major complications. Thus, coronary angioplasty has nowadays obtained a definitive place in the treatment of acute myocardial ischemic syndromes. Further research is needed to improve the initial and late results of coronary angioplasty, and additional randomized clinical studies are necessary to more accurately define the indications and timing of dilatation in these acutely ill patients.

show abstract

“…Therefore, early operative inter vention is important for unsuccessful PTCA, and surgical back-up must be available dur ing balloon angioplasty. It has been sug gested that early 1ABP may play an impor tant role in decreasing morbidity and mor tality in these patients [22][23][24], Our plan for patients undergoing PTCA is similar to that of others [22,25,26]. When the PTCA patients are placed on the operat ing schedule, they are seen prior to PTCA by the attending surgeon and are informed that, if PTCA fails, immediate CAB will be under taken.…”

Section: Ptcamentioning

confidence: 99%

Revascularization of the Ischemic Myocardium: Current Results and Expectations for the Future

Cooley¹

1987

Cardiology

View full text Add to dashboard Cite

Coronary Bypass for Relief of Persistent Pain Following Acute Myocardial Infarction

Cited by 60 publications

References 24 publications

Coronary angioplasty for early postinfarction unstable angina.

Coronary angioplasty for early postinfarction unstable angina.

Indications for coronary angioplasty in acute myocardial ischemic syndromes

Revascularization of the Ischemic Myocardium: Current Results and Expectations for the Future

Contact Info

Product

Resources

About