Kioka Y, Dallan L, Oliveira S, Jatene A
Heart Institute, São Paulo University Medical School, Brazil.
Jpn J Surg. 1991 Nov;21(6):643-9. doi: 10.1007/BF02471049.
From July, 1981 to December, 1988, 2431 percutaneous transluminal coronary angioplasties were performed on 1901 patients at the Heart Institute of São Paulo University Medical School. Seventy-six patients (4.0 per cent) underwent emergency coronary artery bypass grafting for failed angioplasty. The incidence of failed angioplasty was significantly higher in the impending myocardial infarction group (11.5 per cent) than in the angina group (4.8 per cent) and the acute myocardial infarction group (1.3 per cent). The mean age of the seventy-six patients was 54.4 years, and 54 patients were male. The operative mortality was 15.8 per cent, being 9 males and 3 females. Patients who had had a left main trunk dissection during angioplasty and those who were hemodynamically unstable following the failed angioplasty or who had had a cardiac arrest necessitating a cardiac massage during transportation to the operating room, had a higher mortality than patients in whom the failure occurred in other sites and those who were hemodynamically stable. Perioperative myocardial infarction was documented in 50 per cent of the patients. Patients who had had a cardiac arrest during the procedure had a higher rate of perioperative myocardial infarction than those whose preoperative hemodynamic condition was stable.
1981年7月至1988年12月，圣保罗大学医学院心脏研究所对1901例患者进行了2431次经皮腔内冠状动脉成形术。76例患者（4.0%）因血管成形术失败接受了急诊冠状动脉搭桥术。即将发生心肌梗死组血管成形术失败的发生率（11.5%）显著高于心绞痛组（4.8%）和急性心肌梗死组（1.3%）。这76例患者的平均年龄为54.4岁，其中54例为男性。手术死亡率为15.8%，其中9例男性，3例女性。血管成形术期间发生左主干夹层的患者，以及血管成形术失败后血流动力学不稳定或在转运至手术室期间发生心脏骤停需要心脏按压的患者，其死亡率高于失败发生在其他部位且血流动力学稳定的患者。50%的患者记录有围手术期心肌梗死。手术过程中发生心脏骤停的患者围手术期心肌梗死的发生率高于术前血流动力学状况稳定的患者。
