Téllez de Peralta G, Burgos Lázaro R
Servicio de Cirugía Cardiovascular, Hospital Puerta de Hierro, Madrid.
Rev Esp Cardiol. 1998;51 Suppl 3:44-50.
Hospital deaths from acute myocardial infarction are the consequence of cardiac arrhythmias and cardiac pump failure. However, for a limited period of time following the interruption of the coronary blood flow, a significant portion of the myocardium remains in a situation of "reversibility", which means that if the coronary flow is reestablished, the infarcted area is reduced. Pos-acute myocardial infarction reperfusion methods include thrombolytic therapy, percutaneous transluminal coronary angioplasty and surgical revascularization of the myocardium. The indications for the latter method, which is employed when procedures such as thrombolysis and percutaneous transluminal coronary angioplasty have failed, are analyzed and the results are discussed in terms of the time elapsed since the onset of acute myocardial infarction, ejection fraction, the number of vessels involved, the type of infarction and the concurrence of cardiogenic shock. The advisability of adopting different strategies and priorities for surgical revascularization in certain situations is indicated.
医院中急性心肌梗死导致的死亡是心律失常和心脏泵衰竭的结果。然而，在冠状动脉血流中断后的一段有限时间内，很大一部分心肌仍处于“可逆”状态，这意味着如果恢复冠状动脉血流，梗死面积会减小。急性心肌梗死后再灌注方法包括溶栓治疗、经皮腔内冠状动脉成形术和心肌外科血管重建术。分析了后一种方法（在溶栓和经皮腔内冠状动脉成形术等程序失败时采用）的适应症，并根据急性心肌梗死发作后的时间、射血分数、受累血管数量、梗死类型和心源性休克的并发情况讨论了结果。指出了在某些情况下采用不同的外科血管重建策略和优先事项的可取性。
