HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Lazar, H. L. Articles by Shemin, R. J. Search for Related Content PubMed PubMed Citation Articles by Lazar, H. L. Articles by Shemin, R. J.

The Annals of Thoracic Surgery, Vol 53, 269-273, Copyright © 1992 by The Society of Thoracic Surgeons

ARTICLES

Changing profiles of failed coronary angioplasty patients: impact on surgical results

HL Lazar, DP Faxon, G Paone, A Rajaii-Khorasani, AK Jacobs, MP Fallon and RJ Shemin
Department of Cardiothoracic Surgery, Boston University Medical Center, Massachusetts.

As more high-risk patients undergo percutaneous transluminal coronary angioplasty (PTCA), the changing profiles of PTCA patients who may require emergent coronary artery bypass grafting may alter operative morbidity and mortality. This study compared profiles of recent patients undergoing emergent coronary artery bypass grafting after a failed PTCA with earlier patients to determine their impact on operative results. From 1980 to 1988, 53 patients underwent emergent coronary artery bypass grafting after a failed PTCA at the Boston University Medical Center. These patients were divided into two groups based on the year of the PTCA: group I, 1980 to 1985 (n = 18); and group II, 1986 to 1988 (n = 35). Group II patients tended to be older (age greater than or equal to 65 years, 47% group II versus 11% group I), were more likely to have unstable angina before PTCA (74% versus 33%), and had lower ejection fractions (0.53 +/- 0.02 versus 0.63 +/- 0.05) and more vessels with 50% or greater stenosis (2.1 +/- 0.2 versus 1.6 +/- 0.2). Nevertheless, there was no significant difference in the incidence of perioperative myocardial infarcts using enzyme and electrocardiographic criteria (37% in group II versus 39% in group I), 30-day operative mortality (11% in group II versus 11% in group I), or major postoperative complications (14% in group II versus 22% in group I). We conclude that despite the changing profiles of patients undergoing PTCA, which include older patients with more extensive coronary artery disease and lower ejection fractions, operative results after emergent coronary artery bypass grafting for failed PTCAs remain unchanged.

This article has been cited by other articles:

				M. S. Barakate, P. G. Bannon, C. F. Hughes, M. D. Horton, A. Callaway, and T. Hurst Emergency surgery after unsuccessful coronary angioplasty: a review of 15 years' experience Ann. Thorac. Surg., May 1, 2003; 75(5): 1400 - 1405. [Abstract] [Full Text] [PDF]

				S. C. Smith Jr, J. T. Dove, A. K. Jacobs, J. Ward Kennedy, D. Kereiakes, M. J. Kern, R. E. Kuntz, J. J. Popma, H. V. Schaff, D. O. Williams, et al. ACC/AHA guidelines for percutaneous coronary intervention (revision of the 1993 PTCA guidelines): A report of the American College of Cardiology/ American Heart Association Task Force on practice guidelines (Committee to revise the 1993 guidelines for percutaneous transluminal coronary angioplasty) endorsed by the Society for Cardiac Angiography and Interventions J. Am. Coll. Cardiol., June 15, 2001; 37(8): 2239 - 2239. [Full Text] [PDF]

				H. L. Lazar, Y. Bao, D. Lancaster, O. M. Shapira, G. S. Aldea, and R. J. Shemin Favorable impact of stents after emergent coronary artery bypass for failed angioplasty Ann. Thorac. Surg., November 1, 1999; 68(5): 1644 - 1647. [Abstract] [Full Text] [PDF]

				H. L. Lazar, A. K. Jacobs, G. S. Aldea, O. M. Shapira, D. Lancaster, and R. J. Shemin Factors Influencing Mortality After Emergency Coronary Artery Bypass Grafting for Failed Percutaneous Transluminal Coronary Angioplasty Ann. Thorac. Surg., December 1, 1997; 64(6): 1747 - 1752. [Abstract] [Full Text]

				H. L. Lazar, X. Zhang, T. Hamasaki, P. Treanor, S. Rivers, S. Bernard, and R. J. Shemin Role of Leukocyte Depletion During Cardiopulmonary Bypass and Cardioplegic Arrest Ann. Thorac. Surg., December 1, 1995; 60(6): 1745 - 1748. [Abstract] [Full Text]

				H. L. Lazar, X. Zhang, S. Rivers, S. Bernard, and R. J. Shemin Limiting Ischemic Myocardial Damage Using Glucose-Insulin-Potassium Solutions Ann. Thorac. Surg., August 1, 1995; 60(2): 411 - 416. [Abstract] [Full Text]

				N. Wang, S. R. Gundry, G. Van Arsdell, A. J. Razzouk, A. C. Hill, M. Sjolander, K. A. Cavazos, J. M. Brewer, E. E. Vyhmeister, and L. L. Bailey Percurtaneous transluminal coronary angioplasty failures in patients with multivessel diseaseIs there an increased risk? J. Thorac. Cardiovasc. Surg., July 1, 1995; 110(1): 214 - 223. [Abstract] [Full Text]

				H. L. Lazar, P. Treanor, S. Rivers, S. Bernard, and R. J. Shemin Combining Percutaneous Bypass With Coronary Retroperfusion Limits Myocardial Necrosis Ann. Thorac. Surg., February 1, 1995; 59(2): 373 - 378. [Abstract] [Full Text]

				C. Landau, R. A. Lange, and L. D. Hillis Percutaneous Transluminal Coronary Angioplasty N. Engl. J. Med., April 7, 1994; 330(14): 981 - 993. [Full Text]