Early results of emergency surgery after coronary angioplasty.

During the period of our study 81 patients undergoing elective coronary artery angioplasty at our institution required emergency revascularization surgery within the ensuing 24 hr. The mean age of the 59 men and 22 women was 57 years (32 to 74 years). The principal indications for the emergency surgery were acute occlusion (n = 36), dissection (n = 28), unstable angina (n = 10), ventricular arrhythmias (n = 4), and unsuccessful balloon dilatation (n = 3). There were two early deaths and in 35 patients the presence of three criteria for myocardial infarction was noted postoperatively. Including these patients, 52 patients surviving their hospital course suffered 75 major complications. Emergency surgery after failed percutaneous transluminal coronary angioplasty can be performed with low mortality, but it carries a high incidence of major postoperative complications.