Kinoshita T, Makino S, Saito K, Fujii H
Kyobu Geka. 1992 Apr;45(4):294-8.
Of 1,315 consecutive patients undergoing PTCA, 9 eventually underwent emergency CABG because of angioplasty failure (emergency rate 0.68%). The indication for emergency bypass was dissection with threatening occlusion in 3 patients, acute occlusion with evolving MI in 3 patients, cardiogenic shock in 1 patient, intractable cardiac arrest in 2 patients. Eight patients were taken directly to the operating room from the catheterization laboratory. The overall mortality of emergency CABG was 11%. One of the two patients with cardiac arrest died of LOS postoperatively. Two patients developed perioperative myocardial infarction (25%). The incidence of operative morbidity and mortality were significantly increased among patients with hemodynamic instability. Should PTCA failure become evident, the prompt undertaking of emergency CABG could perhaps decrease the incidence of acute MI and death.
在1315例连续接受经皮冠状动脉腔内血管成形术（PTCA）的患者中，有9例最终因血管成形术失败而接受了急诊冠状动脉旁路移植术（CABG）（急诊率为0.68%）。急诊搭桥的指征为：3例患者出现有威胁性闭塞的夹层，3例患者出现急性闭塞并伴有进展性心肌梗死（MI），1例患者出现心源性休克，2例患者出现顽固性心脏骤停。8例患者从心导管室直接被送往手术室。急诊CABG的总体死亡率为11%。2例心脏骤停患者中有1例术后死于败血症。2例患者发生围手术期心肌梗死（25%）。血流动力学不稳定患者的手术发病率和死亡率显著增加。如果PTCA失败变得明显，及时进行急诊CABG可能会降低急性MI和死亡的发生率。
