Skip Navigation

European Heart Journal 1982 3(5):404-415;
Copyright © 1982 by the European Society of Cardiology.
This Article
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrowRequest Permissions
Google Scholar
Right arrow Articles by SERRUYS, P. W.
Right arrow Articles by HUGENHOLTZ, P. G.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by SERRUYS, P. W.
Right arrow Articles by HUGENHOLTZ, P. G.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

© 1982 by The European Society of Cardiology

Coronary recanalization in acute myocardial infarction: immediate results and potential risks

P. W. SERRUYS, M. VAN DEN BRAND, T. E. H. HOOGHOUDT, M. L. SIMOONS, P. FIORETTI, J. RUITER, P. W. FELS and P. G. HUGENHOLTZ*

Thoraxcenter, Erasmus University and University Hospital Dijkzigt Rotterdam, The Netherlands

Received 24 May 1982; .

Requests for reprints to: P. W. Serruys, Catheterization Laboratory, Erasmus University and University Hospital Dijkzigt. Dr Molewaterplein 40, 3000 DR Rotterdam. The Netherlands.

Abstract

Between September 1980 and March 1982, 83 patients were catheterized during the acute phase of their myocardial infarction with the intention to recanalize their infarct-related vessel (IRV); of these 83, 30 participated in a randomized study. Five patients died during the catheterization procedure, two as a result of cardiogenic shock, two of migration of thrombotic material and one of possible heart rupture after a successful recanalization. In 15 patients the IR V was found to be patent at the first coronary injection. In the remaining 64 patients with an occluded IRV, 41 arteries were successfully recanalized.

Of the surviving patients who underwent an attempt at recanalization, 29 had non-fatal complications which required treatment (ventricular fibrillation, ventricular tachycardia or ventricular premature beats, bradycardia, hypotension, artrioventricular block, atrial fibrillation). The complications were predominantly observed in hypotensive patients during angiography after recanalization had been accomplished. Of the 41 successful recanalizations, complications occurred in 20. Of all recanalized right coronary arteries, complications took place in 81%, of the left circumflex arteries in 25% and of the left anterior descending arteries in 24%.

In conclusion, catheterization and attempts at recanalization of occluded arteries impose a substantial risk of fatal and non-fatal complications. These occur in particular during the first angiogram after the re-opening of an occluded right coronary artery. These observations lead to the following recommendations:

(1) streptokinase infusion should not be considered before the circulation is adequately supported:

(2) lidocaine and nifedipine should be administered prophylactically before the attempt at recanalization;

(3) a non-ionic contrast medium should be used for angiography.

Key Words: Acute myocardial infarction • recanalization


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?




Disclaimer:
Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department.