[Emergency aorto-coronary bypass after myocardial infarction].

During a recent three-year period, 37 patients had an emergent aortocoronary bypass (ACB) after evolutive acute myocardial infarction. The patients are divided up into two groups: group I includes 12 patients who were operated after the failure of early thrombolysis; group II includes 25 patients operated after the failure of revascularization through percutaneous angioplasty. In group I, all patients survived and 9 had no postoperative complications. In group II, the outcome was favorable for 16 patients. Long-lasting postoperative inotropic support was required for nine patients. Two patients died early. In all patients of the study, surgery failed to prevent myocardial necrosis but there was no recurrence of angina nor major left ventricular malfunction in the long term. This work suggests that early surgery after acute myocardial infarction may be a rescue procedure, with low risks and good long-term results.