Emergency Coronary Artery Bypass and Cardiopulmonary Bypass

  • Joseph M. Craver


During the past 12 years, percutaneous transluminal coronary angioplasty (PTCA) has undergone remarkable growth as a revascularization modality in the care of patients with coronary artery obstructive disease.1 With the increasing number of institutions offering coronary angioplasty services, an increasing number of cardiac surgical services will be involved in the surgical support of angioplasty patients. Since 4% to 7% of coronary angioplasty procedures result in acute ischemic complications necessitating emergency coronary artery revascularization, the cardiac surgery team must be familiar with the medical and surgical problems associated with this group of patients in their often difficult and urgent clinical circumstances.2 To be successful in managing these failed angioplasty patients, it is essential to establish and maintain cooperative teamwork among the caregivers: the physician who performs the angioplasty, the cardiac anesthesiologist, the cardiac surgeon, the perfusionist, and the operating room nurses.


Acute Myocardial Ischemia Intraaortic Balloon Intracoronary Streptokinase Angioplasty Procedure Intraaortic Balloon Pump 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Gruentzig A. Results from coronary angioplasty and implications for the future. Am Heart J 1982; 103: 779–783.PubMedCrossRefGoogle Scholar
  2. 2.
    Dorros G, Crowley MJ, Simpson J, et al. Percutaneous transluminal coronary angioplasty: report of complications from the National Heart, Lung, and Blood Institute PTCA Registry. Circulation 1983; 67: 723–730.PubMedCrossRefGoogle Scholar
  3. 3.
    Talley JD, Weintraub WS, Roubin, GS, et al. Dailey elective percutaneous transluminal coronary angioplasty requiring coronary artery bypass surgery. Circulation 1990; 82: 1203–1213.PubMedCrossRefGoogle Scholar
  4. 4.
    Murphy DA, Craver JM, Jones EL, et al. Surgical revascularization following unsuccessful percutaneous transluminal coronary angioplasty. J Thorac Cardiovasc Surg 1982; 84: 342–348.PubMedGoogle Scholar
  5. 5.
    Murphy DA, Craver JM, Jones EL, et al. Surgical management of acute myocardial ischemia following PTCA: role of the intraaortic balloon pump. J Thorac Cardiovasc Surg 1984; 87: 332–339.PubMedGoogle Scholar
  6. 6.
    Margolis JR. The role of the percutaneous intraaortic balloon in emergency situations following percutaneous transluminal coronary angioplasty. In Kaltenback M, Gruentzig A, Rentrop K, Bussman WD, eds. Transluminal Coronary Angioplasty and Intracoronary Thrombolysis’ New York: Springer-Verlag; 1982: 144–150.Google Scholar
  7. 7.
    Roubin GS, Douglas JS, Lembo NJ, et al. Intracoronary stents for acute closure following percutaneous transluminal coronary angioplasty (PTCA). Circulation 1988; 78 (suppl): 16–21.CrossRefGoogle Scholar
  8. 8.
    Curling PE, Waller JL, Murphy DA, Craver JM, Jones EL, Freniere S. Resuscitation, monitoring, and anesthesia for failed percutaneous transluminal coronary angioplasty. Abstracts of the 6th Annual Meeting of the Society of Cardiovascular Anesthesiologists, Boston, MA. May 1984:227–228.Google Scholar
  9. 9.
    Salerno TA, Houck JP, Barrozo CA, et al. Retrograde continuous warm blood cardioplegia: a new concept in myocardial protection. Ann Thorac Surg 1991; 51: 245–247.PubMedCrossRefGoogle Scholar
  10. 10.
    Jones EL, Craver JM, Gruentzig AR, et al. Percutaneous transluminal coronary angioplasty: role of the surgeon. Ann Thorac Surg 1982; 34: 493–503.CrossRefGoogle Scholar
  11. 11.
    Kutcher MA, Gruentzig AR, Turina M, Craver JM, Jones EL, Douglas JS, King SB III. Can emergency coronary bypass surgery following acute failure of coronary angioplasty prevent myocardial infarction? Am J Cardiol 1982; 49: 956.CrossRefGoogle Scholar
  12. 12.
    Riemer KA, Lower JE, Rasmussen MM, Jennings RB. The wave front phenomenon of ischemic cell death: myocardial infarct size vs duration of coronary occlusion in dogs. Circulation 1977; 56: 786–794.Google Scholar
  13. 13.
    Anderson JL, Marshall HW, Bray BE, et al. A randomized trial of intracoronary streptokinase in the treatment of acute myocardial infarction. N Engl J Med 1983; 308: 1312–1318.PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag New York Inc. 1995

Authors and Affiliations

  • Joseph M. Craver

There are no affiliations available

Personalised recommendations