Time to reperfusion and other procedural characteristics of emergency coronary artery bypass surgery after unsuccessful coronary angioplasty

A databank search was performed and 148 consecutive patients (mean age 59.5 ± 10.4 years) were identified who underwent emergency coronary artery bypass surgery at the Mayo Clinic between November 20, 1979, and February 12, 1992, immediately after unsuccessful coronary angioplasty. At the end of the...

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Bibliographic Details
Published in:The American journal of cardiology 1995-09, Vol.76 (8), p.565-569
Main Authors: Berger, Peter B., Stensrud, Paul E., Daly, Richard C., Grill, Diane, Bell, Malcolm R., Garratt, Kirk N., Holmes, David R.
Format: Article
Language:English
Subjects:
Aged
Angioplasty
Angioplasty, Balloon, Coronary - statistics & numerical data
Biological and medical sciences
Cardiac Catheterization
Cardiovascular disease
Chi-Square Distribution
Coronary Artery Bypass - statistics & numerical data
Coronary Disease - diagnosis
Coronary Disease - mortality
Coronary Disease - surgery
Disease-Free Survival
Emergencies
Female
Follow-Up Studies
Heart
Humans
Male
Medical sciences
Middle Aged
Myocardial Infarction - mortality
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Surgery of the heart
Survival Analysis
Time Factors
Treatment Failure
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Summary:A databank search was performed and 148 consecutive patients (mean age 59.5 ± 10.4 years) were identified who underwent emergency coronary artery bypass surgery at the Mayo Clinic between November 20, 1979, and February 12, 1992, immediately after unsuccessful coronary angioplasty. At the end of the angioplasty procedure, there was no anterograde coronary blood flow in the treated artery in 54%, ongoing chest pain in 78%, and hemodynamic compromise requiring intravenous vasopressor therapy in 25% of patients; 127 patients (86%) had at least 1 of these adverse characteristics. After leaving the catheterization laboratory, the median time to arrival in the operating room was 12 minutes. Median time from arrival in the operating room to initiation of cardiopulmonary bypass was 86 minutes, to administration or cardioplegia was 98 minutes, and to removal of the aortic cross-clamp was 135 minutes. In-hospital mortality was 11%, and 18% developed nonfatal Q-wave myocardial infarction. Thus, significant time is required to achieve surgical reperfusion after unsuccessful coronary angioplasty.
ISSN:0002-9149
1879-1913
DOI:10.1016/S0002-9149(99)80156-8