Emergency Myocardial Revascularization for Impending Myocardial Infarctions

Acute coronary insufficiency. Review of 46 patients.

“…The operative mortality in 361 cases reported in recent series (Lambert et al, 1971;Cheanvechai et al, 1973;Conti et al, 1973;Fischl et al, 1973;Scanlon et al, 1973;Segal et al, 1973;Bonchek et al, 1974;Berndt et al, 1975) was 9 4 per cent and the perioperative infarct rate 13 per cent. Of the 180 patients who survived surgery and who have been followed for more than 1 year (Conti et al, 1973;Fischl et al, 1973;Segal et al, 1973;Bonchek et al, 1974;Berndt et al, 1975), there has been a late mortality of only 1 per cent per year during a follow-up period of 16 months.…”

“…Angiographic data have confirmed that most of these patients have severe coronary artery disease but they are not as a group distinguishable anatomically from other patients with symptomatic coronary artery disease. Of 408 patients with angiographically documented coronary artery disease and unstable angina reported in 8 series (Lambert et al, 1971;Cheanvechai et al, 1973;Conti et al, 1973;Fischl et al, 1973;Scanlon et al, 1973;Segal et al, 1973;Bonchek et al, 1974;Berndt et al, 1975) (Bruschke et al, 1973).…”

Coronary Artery Reperfusion

“…Previous experimental studies aimed at increasing the oxygen supply to ischemic tissue by reopening an obstructe(l coronary arterv were disappointing in preventing the occurrence of subsequent mvocardial infarctionl, as discussed in (letail in the accompanying report ( 11). How-ever, the technique of aortocoronary bypass -ein grafting has proved promising clinically (16)(17)(18)(19)(20), and the question has again arisen as to the maximum timle interval durinig wliclh mivocardial cells distal to a coronary occlusion can resist ischemia and whether or not restoration of function can be accomplished. ' (4, 5.…”

Current Status of Aorto-Coronary Bypass Graft Surgery

“…It is generally admitted that the early surgical mortality for unstable angina pectoris is higher than for the surgical treatment of chronic stable angina [94][95][96][97][98][99][100], C onti et al [99] reported on 57 consecutive patients with angina of recent onset, changing pattern, or rest angina associated with electrocardiographic ischemic changes during the episodes of pain. Aorto-coronary saphenous vein bypass was performed in 40 patients with a 23% hospital mortality rate and no late deaths [99].…”