Surgical revascularization for acute coronary insufficiency: analysis of risk factors for hospital mortality.

Background: A retrospective study of 444 patients undergoing urgent and emergent coronary artery bypass grafting for acute coronary insufficiency was performed to identify the risk factors for hospital death specifically associated with the clinical severity of the acute coronary insufficiency syndrome.

Methods: The patients were divided into three groups-urgent, emergent A, and emergent B-on the basis of the evolution of the clinical pattern of the acute coronary insufficiency syndrome on full medical treatment. The three categories were defined as follows: urgent (257 patients), surgical revascularization could be delayed for 24 to 36 hours after surgical consultation because of adequate control of ischemia; emergent A (127 patients), prompt myocardial revascularization was required because medical treatment achieved only transient regression of an unrelenting ischemic pattern; and emergent B (60 patients), prompt myocardial revascularization was required because the acute coronary insufficiency was entirely refractory to medical treatment.

[Surgical revascularization in acute coronary insufficiency: an analysis of the risk factors for hospital mortality in urgencies and emergencies].

Objectives: A retrospective analysis of 444 patients (Pts) with acute coronary insufficiency (A.C.I.

A randomized controlled trial of mesentericocaval shunt with autologous jugular vein.

After a large uncontrolled experience, in April 1976, a randomized clinical trial between side-to-side portacaval anastomosis and a mesentericocaval shunt with internal jugular vein interposition was initiated. Up to April 1979, 23 patients were operated upon with a mesentericocaval shunt and 26 with a portacaval anastomosis. With a mean follow-up time of 23 months, no statistically significant differences in terms of operative mortality, hepatic encephalopathy and long term survival were found between the two operations.