The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Nov 1984
Coronary artery bypass for unsuccessful percutaneous transluminal coronary angioplasty.
Of 518 consecutive patients undergoing percutaneous transluminal coronary angioplasty for 571 coronary lesions, 184 eventually underwent coronary artery bypass because of angioplasty failure. Delayed coronary bypass (1 week to 19 months) was done in 27 patients with no deaths. Immediate bypass was done in 87 patients with two deaths, both of which were caused by further dissection of the artery after angioplasty. ⋯ In the 10 patients in whom extracorporeal circulation was established within 25 minutes of myocardial insult, mortality and myocardial complications were completely avoided. The remaining patients in the urgent group were placed on cardiopulmonary bypass within 26 to 300 minutes (mean 82 minutes). Operative mortality (3.3%), completed myocardial infarction (6.0%), myocardial infarction in unstable patients (32.9%), postoperative hemorrhage (5.0%), and sternal problems (2.8%) were all significantly different from those in 3,500 consecutive coronary bypasses not following angioplasty, that were done in 1982.
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J. Thorac. Cardiovasc. Surg. · Nov 1984
The St. Jude Medical bileaflet valve prosthesis. A 5 year experience.
A 5 year experience with the bileaflet St. Jude Medical valve is reported. Between March, 1978, and June, 1982, 198 patients received 233 such valves (90 mitral, 73 aortic, and 35 double mitral-aortic valve replacements). ⋯ This intermediate experience with the St. Jude Medical valve indicates that, in addition to its previously demonstrated excellent hemodynamic performance, there have been no instances of primary structural failure or hemolysis. Warfarin anticoagulation is recommended in all patients.