Have PTCA failures requiring emergent bypass operation changed?
From 1980 through 1990, 9,145 patients had balloon angioplasty with failure of the procedure requiring emergent surgical revascularization within 24 hours occurring in 253 patients (2.8%). Patients were divided into two cohorts based on the date of the percutaneous transluminal coronary angioplasty...
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| Veröffentlicht in: | The Annals of thoracic surgery 1995-02, Vol.59 (2), p.283-287 |
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| container_title | The Annals of thoracic surgery |
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| creator | Boylan, Mary J. Lytle, Bruce W. Taylor, Paul C. Loop, Floyd D. Proudfit, William Borsh, Judith A. Cosgrove, Delos M. |
| description | From 1980 through 1990, 9,145 patients had balloon angioplasty with failure of the procedure requiring emergent surgical revascularization within 24 hours occurring in 253 patients (2.8%). Patients were divided into two cohorts based on the date of the percutaneous transluminal coronary angioplasty (PTCA): 1980 to 1985 (n = 109) and 1986 to 1990 (n = 144). The incidence of PTCA failure was 3.8% during 1980 to 1985 (109/2,903) and decreased to 2.3% (144/6,242) for 1986 to 1990. Comparison of pre-PTCA patient characteristics between the two periods showed that only a history of a previous PTCA and class III or class IV symptoms were more common in the recent years (
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| doi_str_mv | 10.1016/0003-4975(94)00943-2 |
| format | Article |
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p <- 0.05). In-hospital mortality after emergency operation was 4.6% (5/109) during 1980 to 1985 and 7.6% (11/144) from 1985 to 1990 (
p = not significant). This trend toward increased mortality appeared to be related to an increased number of patients who underwent operation in a state of severe hemodynamic compromise in the more recent period. The in-hospital mortality rate for patients in shock or undergoing cardiopulmonary resuscitation was 28.3% (13/46) compared with 1.4% (3/207) for patients with less severe hemodynamic derangement (
p < 0.001). Use of the intraaortic balloon pump preoperatively increased from 12.8% to 32.6% (
p < 0.01). Late survival was 92% at 2 and 87% at 5 postoperative years. Although the incidence of PTCA failure necessitating emergent surgical intervention has decreased over time, there has been a trend toward an increased in-hospital mortality rate for those patients that does not appear to be related to more severe pre-PTCA characteristics. This trend does correlate with an increased prevalence of severe hemodynamic compromise in patients needing emergent operation and has occurred despite increased use of intraaortic balloon pump support.</description><identifier>ISSN: 0003-4975</identifier><identifier>EISSN: 1552-6259</identifier><identifier>DOI: 10.1016/0003-4975(94)00943-2</identifier><identifier>PMID: 7847938</identifier><language>eng</language><publisher>Netherlands: Elsevier Inc</publisher><subject>Angioplasty, Balloon, Coronary ; Cardiopulmonary Resuscitation ; Coronary Artery Bypass ; Coronary Disease - mortality ; Coronary Disease - therapy ; Emergencies ; Female ; Hospital Mortality ; Humans ; Intra-Aortic Balloon Pumping ; Male ; Middle Aged ; Retrospective Studies ; Survival Rate ; Treatment Failure</subject><ispartof>The Annals of thoracic surgery, 1995-02, Vol.59 (2), p.283-287</ispartof><rights>1995 The Society of Thoracic Surgeons</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c392t-e25b9d709372801bf9c450b5c7fddb2a7648fd13f6ad23ed84c42f63706460873</citedby><cites>FETCH-LOGICAL-c392t-e25b9d709372801bf9c450b5c7fddb2a7648fd13f6ad23ed84c42f63706460873</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/0003-4975(94)00943-2$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,778,782,3539,27907,27908,45978</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/7847938$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Boylan, Mary J.</creatorcontrib><creatorcontrib>Lytle, Bruce W.</creatorcontrib><creatorcontrib>Taylor, Paul C.</creatorcontrib><creatorcontrib>Loop, Floyd D.</creatorcontrib><creatorcontrib>Proudfit, William</creatorcontrib><creatorcontrib>Borsh, Judith A.</creatorcontrib><creatorcontrib>Cosgrove, Delos M.</creatorcontrib><title>Have PTCA failures requiring emergent bypass operation changed?</title><title>The Annals of thoracic surgery</title><addtitle>Ann Thorac Surg</addtitle><description>From 1980 through 1990, 9,145 patients had balloon angioplasty with failure of the procedure requiring emergent surgical revascularization within 24 hours occurring in 253 patients (2.8%). Patients were divided into two cohorts based on the date of the percutaneous transluminal coronary angioplasty (PTCA): 1980 to 1985 (n = 109) and 1986 to 1990 (n = 144). The incidence of PTCA failure was 3.8% during 1980 to 1985 (109/2,903) and decreased to 2.3% (144/6,242) for 1986 to 1990. Comparison of pre-PTCA patient characteristics between the two periods showed that only a history of a previous PTCA and class III or class IV symptoms were more common in the recent years (
p <- 0.05). In-hospital mortality after emergency operation was 4.6% (5/109) during 1980 to 1985 and 7.6% (11/144) from 1985 to 1990 (
p = not significant). This trend toward increased mortality appeared to be related to an increased number of patients who underwent operation in a state of severe hemodynamic compromise in the more recent period. The in-hospital mortality rate for patients in shock or undergoing cardiopulmonary resuscitation was 28.3% (13/46) compared with 1.4% (3/207) for patients with less severe hemodynamic derangement (
p < 0.001). Use of the intraaortic balloon pump preoperatively increased from 12.8% to 32.6% (
p < 0.01). Late survival was 92% at 2 and 87% at 5 postoperative years. Although the incidence of PTCA failure necessitating emergent surgical intervention has decreased over time, there has been a trend toward an increased in-hospital mortality rate for those patients that does not appear to be related to more severe pre-PTCA characteristics. This trend does correlate with an increased prevalence of severe hemodynamic compromise in patients needing emergent operation and has occurred despite increased use of intraaortic balloon pump support.</description><subject>Angioplasty, Balloon, Coronary</subject><subject>Cardiopulmonary Resuscitation</subject><subject>Coronary Artery Bypass</subject><subject>Coronary Disease - mortality</subject><subject>Coronary Disease - therapy</subject><subject>Emergencies</subject><subject>Female</subject><subject>Hospital Mortality</subject><subject>Humans</subject><subject>Intra-Aortic Balloon Pumping</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Retrospective Studies</subject><subject>Survival Rate</subject><subject>Treatment Failure</subject><issn>0003-4975</issn><issn>1552-6259</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1995</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kEtLw0AQxxdRaq1-A4WcRA_RfSWbvVhKUSsU9FDPy2Z3UlfyqLtJod_exJYePQ3D_zHMD6Frgh8IJukjxpjFXIrkTvJ7jCVnMT1BY5IkNE5pIk_R-Gg5RxchfPcr7eURGomMC8myMZou9Baij9V8FhXalZ2HEHn46Zx39TqCCvwa6jbKdxsdQtRswOvWNXVkvnS9Bju9RGeFLgNcHeYEfb48r-aLePn--jafLWPDJG1joEkurcCSCZphkhfS8ATniRGFtTnVIuVZYQkrUm0pA5txw2mRMoFTnuJMsAm63fdufPPTQWhV5YKBstQ1NF1QQhCWkJT2Rr43Gt-E4KFQG-8q7XeKYDVwUwMUNUBRkqs_bmqI3Rz6u7wCewwdQPX6016H_smtA6-CcVAbsM6DaZVt3P8HfgGHHXs4</recordid><startdate>19950201</startdate><enddate>19950201</enddate><creator>Boylan, Mary J.</creator><creator>Lytle, Bruce W.</creator><creator>Taylor, Paul C.</creator><creator>Loop, Floyd D.</creator><creator>Proudfit, William</creator><creator>Borsh, Judith A.</creator><creator>Cosgrove, Delos M.</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>19950201</creationdate><title>Have PTCA failures requiring emergent bypass operation changed?</title><author>Boylan, Mary J. ; Lytle, Bruce W. ; Taylor, Paul C. ; Loop, Floyd D. ; Proudfit, William ; Borsh, Judith A. ; Cosgrove, Delos M.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c392t-e25b9d709372801bf9c450b5c7fddb2a7648fd13f6ad23ed84c42f63706460873</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1995</creationdate><topic>Angioplasty, Balloon, Coronary</topic><topic>Cardiopulmonary Resuscitation</topic><topic>Coronary Artery Bypass</topic><topic>Coronary Disease - mortality</topic><topic>Coronary Disease - therapy</topic><topic>Emergencies</topic><topic>Female</topic><topic>Hospital Mortality</topic><topic>Humans</topic><topic>Intra-Aortic Balloon Pumping</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Retrospective Studies</topic><topic>Survival Rate</topic><topic>Treatment Failure</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Boylan, Mary J.</creatorcontrib><creatorcontrib>Lytle, Bruce W.</creatorcontrib><creatorcontrib>Taylor, Paul C.</creatorcontrib><creatorcontrib>Loop, Floyd D.</creatorcontrib><creatorcontrib>Proudfit, William</creatorcontrib><creatorcontrib>Borsh, Judith A.</creatorcontrib><creatorcontrib>Cosgrove, Delos M.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The Annals of thoracic surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Boylan, Mary J.</au><au>Lytle, Bruce W.</au><au>Taylor, Paul C.</au><au>Loop, Floyd D.</au><au>Proudfit, William</au><au>Borsh, Judith A.</au><au>Cosgrove, Delos M.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Have PTCA failures requiring emergent bypass operation changed?</atitle><jtitle>The Annals of thoracic surgery</jtitle><addtitle>Ann Thorac Surg</addtitle><date>1995-02-01</date><risdate>1995</risdate><volume>59</volume><issue>2</issue><spage>283</spage><epage>287</epage><pages>283-287</pages><issn>0003-4975</issn><eissn>1552-6259</eissn><abstract>From 1980 through 1990, 9,145 patients had balloon angioplasty with failure of the procedure requiring emergent surgical revascularization within 24 hours occurring in 253 patients (2.8%). Patients were divided into two cohorts based on the date of the percutaneous transluminal coronary angioplasty (PTCA): 1980 to 1985 (n = 109) and 1986 to 1990 (n = 144). The incidence of PTCA failure was 3.8% during 1980 to 1985 (109/2,903) and decreased to 2.3% (144/6,242) for 1986 to 1990. Comparison of pre-PTCA patient characteristics between the two periods showed that only a history of a previous PTCA and class III or class IV symptoms were more common in the recent years (
p <- 0.05). In-hospital mortality after emergency operation was 4.6% (5/109) during 1980 to 1985 and 7.6% (11/144) from 1985 to 1990 (
p = not significant). This trend toward increased mortality appeared to be related to an increased number of patients who underwent operation in a state of severe hemodynamic compromise in the more recent period. The in-hospital mortality rate for patients in shock or undergoing cardiopulmonary resuscitation was 28.3% (13/46) compared with 1.4% (3/207) for patients with less severe hemodynamic derangement (
p < 0.001). Use of the intraaortic balloon pump preoperatively increased from 12.8% to 32.6% (
p < 0.01). Late survival was 92% at 2 and 87% at 5 postoperative years. Although the incidence of PTCA failure necessitating emergent surgical intervention has decreased over time, there has been a trend toward an increased in-hospital mortality rate for those patients that does not appear to be related to more severe pre-PTCA characteristics. This trend does correlate with an increased prevalence of severe hemodynamic compromise in patients needing emergent operation and has occurred despite increased use of intraaortic balloon pump support.</abstract><cop>Netherlands</cop><pub>Elsevier Inc</pub><pmid>7847938</pmid><doi>10.1016/0003-4975(94)00943-2</doi><tpages>5</tpages></addata></record> |
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| ispartof | The Annals of thoracic surgery, 1995-02, Vol.59 (2), p.283-287 |
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| source | MEDLINE; Elsevier ScienceDirect Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Alma/SFX Local Collection |
| subjects | Angioplasty, Balloon, Coronary Cardiopulmonary Resuscitation Coronary Artery Bypass Coronary Disease - mortality Coronary Disease - therapy Emergencies Female Hospital Mortality Humans Intra-Aortic Balloon Pumping Male Middle Aged Retrospective Studies Survival Rate Treatment Failure |
| title | Have PTCA failures requiring emergent bypass operation changed? |
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