July 1972

Emergency Bypass Surgery in Impending and Complicated Acute Myocardial Infarction

Author Affiliations

Los Angeles
From the departments of thoracic, cardiac and vascular surgery, and cardiology, Cedars-Sinai Medical Center, Los Angeles.

Arch Surg. 1972;105(1):30-35. doi:10.1001/archsurg.1972.04180070028005

Emergency aorto-coronary vein bypass was performed in 20 patients: 11 with impending infarction, two with impending infarction and cardiogenic shock, three with acute infarction and continued angina, and four with acute infarction and cardiogenic shock. Nineteen survived and experienced marked clinical improvement.

Left ventricular function was evaluated postoperatively in 12 patients. In six of eight patients with impending infarction, and reduced preoperative values for ejection fraction, segmental wall motion, and contractility, there was great improvement postoperatively. Two patients with impending infarction and cardiogenic shock showed normal left ventricular function postoperatively, but two with acute infarction and cardiogenic shock were left with subnormal left ventricular function.