The Journal of Thoracic and Cardiovascular Surgery, Vol 72, 593-595, Copyright © 1976 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
Surgical management of life-threatening coronary artery disease: experience in 18 consecutive patients with left main trunk or equivalent coronary artery obstruction associated with an obstructed or a nondominant right coronary artery
JM Garcia, LA Mispireta, NP Smyth, JM Keshishian, HB Marsh and JM Bacos
Eighteen patients with obstruction of the left main trunk or equivalent
coronary artery associated with an obstructed or a nondominant right
coronary artery were studied. All patients had coronary artery bypass
surgery because of their symptoms and coronary anatomy. Five patients had
coronary artery bypass without the use of preoperative elective
intra-aortic balloon counterpulsation, and 3 of these patients had cardiac
arrest prior to insertion of the grafts. The other 13 patients received
elective intra-aortic balloon counterpulsation prior to induction of
anesthesia and cannulation. None in this second group of patients developed
any hypotensive episodes or cardiac arrest, and all have done well
following the bypass operation. This experience suggests that the use of
elective preoperative intra-aortic balloon assist in patients who have a
very critical coronary artery obstruction is indicated in view of the high
incidence of cardiac arrest observed in patients who did not receive the
preoperative elective intra-aortic balloon support.
