[Clinical outcome of emergency coronary artery bypass grafting for acute myocardial infarction with cardiogenic shock].
From January 1993 through December 1998, Emergency Coronary Artery Bypass Grafting was Performed within 24 Hours after the Onset of Acute Myocardial Infarction (AMI) with Cardiogenic Shock in 22 Patients (17 men and 5 women; aged, 52-81 years). The incidence of AMI involving the left main coronary artery was 50%. The incidence of interventional therapy was 40.9% (PTCA 31.8%; PTCR 9.1%). The condition in 95.5% of the patients could be stabilized hemodynamically by preoperative intraaortic balloon pumping; 4 of the 5 patients suffered from cardiopulmonary arrest required percutaneous cardiopulmonary support. There were 4 (18.2%) deaths overall. Operative mortality was related to the intervals between AMI and operation (less than 6 hours, 25%; 6 to 24 hours, 10%). Three of the 4 patients who received cardiopulmonary support survived. We conclude that early revascularization and minimal reperfusion injury caused by mechanical devices are important determinants of survival in patients who have AMI with cardiogenic shock.
Tobe
M
M
First Department of Surgery, Yokohama City University Urafune Hospital, Japan.
Kondo
J
J
Suzuki
S
S
Isoda
S
S
Takanashi
Y
Y
Uchida
K
K
Sugiyama
M
M
D000368:Aged; D000369:Aged, 80 and over; D001026:Coronary Artery Bypass; D004638:Emergency Treatment; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000601:surgery*; D012770:Shock, Cardiogenic / Q000150:complications*; D016896:Treatment Outcome