Surgical therapies for post-myocardial infarction patients

The American Journal of Cardiology
Patrick M McCarthy

Abstract

Occasionally, high-risk patients in the post-myocardial infarction (MI) period require surgical intervention for stabilization and/or revascularization. In a meta-analysis involving 3,088 patients with ischemic heart disease, revascularization was associated with nearly an 80% reduction in the risk of death. Coronary artery bypass graft (CABG) surgery is commonly performed in post-MI patients and is associated with more favorable outcomes than medical therapy. However, several factors have to be considered in proper patient selection for CABG, such as the left ventricular ejection fraction (LVEF), severity of heart failure (HF), and myocardial viability. The ongoing Surgical Treatment for Ischemic Heart Failure (STICH) trial will assess the benefits of CABG in patients with both a low LVEF and HF. Unstable post-MI patients who fail revascularization can be managed via mechanical circulatory support devices or pumps. These options significantly improve hemodynamic parameters. In addition, other surgical techniques, such as mitral valve repair, ventricular reconstruction surgery, and atrial fibrillation ablation, are being evaluated in patients with ischemic heart disease.

References

Nov 5, 2003·Current Opinion in Cardiology·David JoyceGuillermo Torre-Amione
Mar 6, 2004·The Journal of Thoracic and Cardiovascular Surgery·Hari R MallidiStephen E Fremes
Oct 7, 2004·Journal of the American College of Cardiology·Constantine L AthanasuleasUNKNOWN RESTORE group
Feb 1, 2005·The Annals of Thoracic Surgery·B-Khanh LamDelos M Cosgrove
Dec 22, 2005·The Annals of Thoracic Surgery·Fred H EdwardsUNKNOWN Society of Thoracic Surgeons
May 9, 2006·The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation·Wakkas TayaraNicholas Smedira
Oct 7, 2006·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·James O O'NeillNicholas Smedira
Nov 15, 2006·European Heart Journal·Nick Clappers, Freek W A Verheugt
Feb 20, 2007·Nutrition, Metabolism, and Cardiovascular Diseases : NMCD·Jeanette J McCarthy

❮ Previous
Next ❯

Citations

Oct 3, 2008·The American Journal of Cardiology·Matthew E HarinsteinMihai Gheorghiade
Oct 3, 2008·The American Journal of Cardiology·James D FlahertyCharles J Davidson

❮ Previous
Next ❯

Related Concepts

Related Feeds

Cardiomyopathy

Cardiomyopathy is a disease of the heart muscle, that can lead to muscular or electrical dysfunction of the heart. It is often an irreversible disease that is associated with a poor prognosis. There are different causes and classifications of cardiomyopathies. Here are the latest discoveries pertaining to this disease.

Atrial Filbrillation

Atrial fibrillation refers to the abnormal heart rhythm characterized by rapid and irregular beating of the atria. Here is the latest research.

Cardiovascular Diseases: Risk Factors

Cardiovascular disease is a significant health concern. Risk factors include hypertension, obesity, dyslipidemia and smoking. Women who are postmenopausal are at an increased risk of heart disease. Here is the latest research for risk factors of cardiovascular disease.

Atrial Fibrillation

Atrial fibrillation is a common arrhythmia that is associated with substantial morbidity and mortality, particularly due to stroke and thromboembolism. Here is the latest research.

Arrhythmia

Arrhythmias are abnormalities in heart rhythms, which can be either too fast or too slow. They can result from abnormalities of the initiation of an impulse or impulse conduction or a combination of both. Here is the latest research on arrhythmias.

Brain Ischemia

Brain ischemia is a condition in which there is insufficient blood flow to the brain to meet metabolic demand. Discover the latest research on brain ischemia here.