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Titolo:
Acute myocardial infarction late after coronary artery bypass grafting: angiographic findings and results of an invasive approach
Autore:
Waldecker, B; Waas, W; Haberbosch, W; Voss, R; Goedecke, M; Tillmanns, H;
Indirizzi:
Univ Giessen, Zentrum Innere Med, Med Klin 1, D-35392 Giessen, Germany Univ Giessen Giessen Germany D-35392 ed Klin 1, D-35392 Giessen, Germany
Titolo Testata:
ZEITSCHRIFT FUR KARDIOLOGIE
fascicolo: 10, volume: 88, anno: 1999,
pagine: 868 - 874
SICI:
0300-5860(199910)88:10<868:AMILAC>2.0.ZU;2-0
Fonte:
ISI
Lingua:
GER
Soggetto:
INTRAVENOUS STREPTOKINASE; IMMEDIATE ANGIOPLASTY; THROMBOLYTIC THERAPY; SURGERY;
Keywords:
myocardial infarction; coronary artery bypass grafting; PTCA; mortality;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
20
Recensione:
Indirizzi per estratti:
Indirizzo: Waldecker, B Univ Giessen, Zentrum Innere Med, Med Klin 1, Klin Str 36, D-35392 Giessen, Germany Univ Giessen Klin Str 36 Giessen Germany D-35392 en, Germany
Citazione:
B. Waldecker et al., "Acute myocardial infarction late after coronary artery bypass grafting: angiographic findings and results of an invasive approach", Z KARDIOL, 88(10), 1999, pp. 868-874

Abstract

Patients who have undergone coronary artery bypass grafting may develop acute myocardial infarction late after surgery. It is not exactly known in these patients whether acute infarction is predominantly caused by occlusion of bypass or native vessels. Also, there is no systematic and prospective data available with respect to an invasive, revascularizing therapeutic approach. Therefore, acute coronary angiograms were obtained in 21 consecutive patients with acute infarctions and remote bypass grafting to elucidate mechanisms causing myocardial infarction in these patients, and to assess results of catheter-based recanalization. Infarction was caused by acute graft occlusion in 12/21 patients. Fibrinolysis and/or PTCA of grafts was successful in 6/8 attempts, direct PTCA of anative vessel was effective in 1/2 patients, 1 patient underwent emergencyre-CABG, and another patient was treated noninvasively. Occlusion of native, ungrafted vessel caused infarction in 9 patients. Direct PTCA of native vessels was effective in 6/7 of those patients, I patient had re-CABG, and another patient was treated non-invasively. Together, catheter-based recanalization was obtained in 13/17 attempts. Thirty-day and 1 year mortality (after discharge) was 5% (1/21 patients) and 12%, respectively. Predischarge ejection fraction was 46%. In conclusion, acute occlusion of bypass grafts is responsible for about half of all cases of myocardial infarction in patients late after surgery. Direct angiography and individually tailored catheter-based recanalization in patients with acute myocardial infarction late after surgery yield promising results.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 06/04/20 alle ore 08:40:11