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[Emergency surgery for PTCA complications: tactics and results]
R Siebenmann1, L Egloff, H O Hirzel
1HerzZentrum Hirslanden, Zürich.
Helvetica Chirurgica Acta
|January 1, 1991
Summary
Emergency coronary bypass surgery after failed percutaneous transluminal coronary angioplasty (PTCA) shows low risk and good outcomes. Prompt surgery is key, though infarction rates are higher than elective procedures.
Area of Science:
- Cardiovascular Surgery
- Interventional Cardiology
- Emergency Medicine
Context:
- Percutaneous transluminal coronary angioplasty (PTCA) is a common procedure for coronary artery disease.
- Failed PTCA, defined by dissection or occlusion with acute symptoms, necessitates urgent intervention.
- Emergency coronary bypass surgery is a potential treatment for failed PTCA.
Purpose:
- To analyze the incidence, risks, and outcomes of emergency coronary bypass surgery following failed PTCA.
- To evaluate the safety and efficacy of immediate surgical intervention after PTCA failure.
Summary:
- A retrospective study of 23 patients (5% of 433 undergoing PTCA) who required emergency coronary bypass surgery due to failed PTCA.
- No early or late deaths were observed; 21 patients were in NYHA class I at 14.3-month follow-up.
- The perioperative infarction rate was 30%, higher than elective surgery, but internal mammary artery use showed no increased risk.
Impact:
- Emergency coronary bypass surgery after failed PTCA can be performed with low mortality and favorable long-term results.
- Timely surgical intervention is crucial for optimal outcomes in PTCA failure.
- Findings support the safety of internal mammary artery use in this high-risk patient group.