Immediate prognosis and five year survival after arterial embolectomy following myocardial infarction.

One hundred and twenty-two patients with 135 arterial emboli, 31 of whom had had a recent myocardial infarction, were seen during a 12 year period. Six patients died after embolectomy, resulting in a 19 per cent in-hospital mortality, and in five patients, amputation was required. The median time from infarction to embolization was 14 days. Length of follow-up period after operation ranged from four to 73 months, with a mean of 36 months. Life table analysis of patients alive 30 days after operation revealed a cumulative five year survival rate of only 26 per cent, recurrent myocardial infarction being responsible for 60 per cent of the deaths. This is in contrast with an approximate 60 to 70 per cent five year survival rate reported in the literature for patients having an infarction only. Although the immediate mortality was greater than that for patients with arterial emboli without infarction, an aggressive approach directed toward limb salvage is urged in these patients, as manifested by the 84 per cent salvage rate in this series.