Bonchek L I, Olinger G N
J Thorac Cardiovasc Surg. 1979 Jul;78(1):147-9.
Major noncardiac surgery is a serious hazard to patients with advanced coronary disease. Perioperative infarction is common, and preliminary coronary bypass is often unwarranted. We suggest that the use of the intra-aortic balloon pump (IABP) for perioperative support of such patients makes perioperative infarction unlikely and permits otherwise hazardous operations. Three patients with advanced coronary disease (unstable angina in two) had major thoracotomies for lung masses without cardiac complications. This management plan has wider implications for other noncardiac surgical problems in such patients, particularly for mandatory operations wuch as relieving intestinal obstructions.
重大非心脏手术对晚期冠心病患者是一种严重危害。围手术期梗死很常见，而且初步的冠状动脉搭桥术往往没有必要。我们建议，对这类患者使用主动脉内球囊反搏（IABP）进行围手术期支持可使围手术期梗死不太可能发生，并允许进行原本具有危险性的手术。三名晚期冠心病患者（其中两名患有不稳定型心绞痛）接受了开胸大手术以切除肺部肿块，未出现心脏并发症。这种管理方案对此类患者的其他非心脏手术问题具有更广泛的意义，特别是对于诸如解除肠梗阻等必须进行的手术。
