Failed angioplasty with cardiac arrest: Survival characteristics and outcomes from the national registry for emergency cardiopulmonary bypass investigators

Published

Journal Article

Purpose: To identify patients (pts.) receiving emergency cardiopulmonary bypass (ECPB) due to angioplasty failure (PTCA-F); to evaluate pt. outcomes which delineate clinical features associated with successful application of CPB. Methods: Consecutive data from each center is submitted prospectively. Results: Cardiac arrest (CA) pts. represent the largest subset of the ECPB population at 68% (205/300). PTCA-F accounted for 36% of CA pts (74/205). Overall, 23/74 (39%) of this pt. series survived to one year. Survivors had a mean ejection fraction (EF) of 45% vs 33% in nonsurvivors (p<0.0071). Pts. having surgery (41/74 or 57%) after initiation of ECPB had a survival rate of 50% (21/42) at one year. The remaining 32 (43%) pts. were treated with repeat PTCA or medically, with only 8 (25%) pts. surviving to one year. Comparison of Flow Time Minutes (Graph Presented) Conclusions: The use of ECPB for hemodynamically compromised pts. after PTCA-F represents an important and life saving application of this pt. support system. Clinical Implications: Survival rates are enhanced by rapid application (<12 minutes) in pts. with preserved EF (≥45%) when ECPB is applied as a temporizing method (flow time <120 minutes) until definitive treatment can be employed. Subsequent revascularization surgery allows higher survival.

Duke Authors

Cited Authors

  • Overlie, PA; Shawl, FA; Vogel, RA; Mooney, MR; Smith, SC; Stertzer, S; Freedman, RJ; Ohman, EM; Teirstein, PS; George, BS; Moore, KE

Published Date

  • October 1, 1996

Published In

Volume / Issue

  • 110 / 4 SUPPL.

International Standard Serial Number (ISSN)

  • 0012-3692

Citation Source

  • Scopus