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Related Experiment Videos

Emergency revascularization for unstable angina

L A Golding, F D Loop, W C Sheldon

    Circulation
    |December 1, 1978
    PubMed
    Summary
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    Emergency revascularization for unstable angina may salvage myocardium but risks perioperative infarction. Some patients already had myocardial infarction before surgery, suggesting a need for ischemia management before definitive treatment.

    Area of Science:

    • Cardiology
    • Vascular Surgery

    Background:

    • Unstable angina requires prompt intervention.
    • Defining optimal timing for revascularization in unstable angina is crucial.

    Purpose of the Study:

    • To evaluate the outcomes of emergency revascularization in patients with unstable angina.
    • To assess the safety and efficacy of immediate surgical intervention.

    Main Methods:

    • 100 consecutive patients with unstable angina underwent emergency revascularization.
    • Patient data included vessel disease severity and left main trunk obstruction.
    • Follow-up included clinical assessment and postoperative angiography.

    Main Results:

    • 4 operative deaths (3 from myocardial infarction) occurred.

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  • 18% of early survivors sustained perioperative infarction.
  • Mean graft patency was 86% at 14 months, with 72% of survivors symptom-free at 42 months.

    • Conclusions:

    • Emergency revascularization can salvage myocardium but carries risks of perioperative infarction.
    • In some cases, myocardial infarction may precede surgery, indicating a need for ischemia management and diagnostic evaluation first.