Ischemic myocardial injury following aorto-coronary bypass surgery.

To assess the incidence of acute myocardial injury following aorto-coronary bypass surgery 151 patients (136 men and 15 women) were evaluated by studying serial preoperative and postoperative ECGs and SGOT, LDH and CPK levels. The mean age of men was 49.1 and of women, 53.1 years. Following surgery 15 patients (group I, 9.9 percent) developed new myocardial infarction as judged by Q wave criteria, 33 patients (group II, 22.5 percent) developed significant ST-T changes, and 103 patients (group III, 68 percent) had no significant ECG change. Mean postoperative SGOT values were: group I,126.2; group II, 100.6; and group III, 72.8. Only the difference in SGOT values between group I and III was significant (P less than 0.01). There was no correlation between type and site of surgery and the incidence of myocardial infarction. There were five deaths (3.3 percent). The combination of death and diagnosed myocardial infarction amounted to 12.6 percent of patients for this widely used elective procedure.

[1]  J. Matloff,et al.  New Q waves after aortocoronary bypass surgery. Unmasking of an old infarction. , 1974, The New England journal of medicine.

[2]  M. Miyagawa,et al.  Ischemic myocardial injury during cardiopulmonary bypass surgery. , 1973, American heart journal.

[3]  A. Starr,et al.  Direct revascularization of the heart. Early clinical experience with 200 patients. , 1972, The Journal of thoracic and cardiovascular surgery.

[4]  W. Winters,et al.  Follow-up results of distal coronary artery bypass for ischemic heart disease. , 1972, The American journal of cardiology.

[5]  D. Cooley,et al.  Myocardial revascularization using combined endarterectomy and vein bypass autograft. Technique and results. , 1971, International surgery.

[6]  M. Miyagawa,et al.  Ischemic myocardial injury during coronary artery surgery. , 1971, American heart journal.

[7]  U. Page,et al.  Revascularization of the heart. Aortocoronary bypass in sixty-three patients. , 1971, American journal of surgery.

[8]  D. Ross,et al.  Coronary Artery Surgery , 1971, Proceedings of the Royal Society of Medicine.

[9]  R. Frye,et al.  Serum glutamic oxaloacetic transaminase and electrocardiographic changes after myocardial revascularization procedures in patients with coronary artery disease. , 1970, The American journal of cardiology.

[10]  W. C. Sheldon,et al.  Reconstructive coronary artery surgery. Venous autograft technique. , 1970, JAMA.

[11]  I. Rubin,et al.  Transient electrocardiographic changes simulating myocardial infarction during open-heart surgery. , 1970, American heart journal.

[12]  W. Proudfit,et al.  Serum enzyme and electrocardiographic changes after coronary artery surgery. Correlation with selective cine coronary arteriography and left ventriculography. , 1970, Chest.

[13]  E. Diethrich,et al.  Serum enzyme and electrocardiographic changes immediately following myocardial revascularization. , 1968, The Annals of thoracic surgery.

[14]  D. Killen Serum enzyme elevations. A diagnostic test for acute myocardial infarction during the early postoperative period. , 1968, Archives of surgery.

[15]  Hamolsky Mw Enzymes in acute myocardial infarction. , 1967 .

[16]  G. Kessler,et al.  The automated determination of NAD-coupled enzymes. II. Serum lactate dehydrogenase. , 1966, Clinical chemistry.

[17]  S. Dack POSTOPERATIVE MYOCARDIAL INFARCTION. , 1963, The American journal of cardiology.

[18]  S. Blount,et al.  The response of the serum glutamic oxalacetic transaminase to open-heart operation. , 1960, American heart journal.

[19]  R. J. Henry,et al.  Revised spectrophotometric methods for the determination of glutamic-oxalacetic transaminase, glutamic-pyruvic transaminase, and lactic acid dehydrogenase. , 1960, Technical bulletin of the Registry of Medical Technologists. American Society of Clinical Pathologists. Registry of Medical Technologists.

[20]  E. Simonson,et al.  The Electrocardiogram in Population Studies: A Classification System , 1960, Circulation.

[21]  I. T. Oliver A spectrophotometric method for the determination of creatine phosphokinase and myokinase. , 1955, The Biochemical journal.

[22]  C. Beck Revascularization of the heart. , 1948, Surgery.

[23]  R. Litwak,et al.  New Q waves after coronary artery bypass for angina pectoris , 1973 .

[24]  David O. Williams,et al.  Myocardial infarction during coronary artery bypass surgery , 1973 .

[25]  E. Diethrich,et al.  Vectorcardiographic changes following saphenous vein coronary bypass surgery , 1973 .

[26]  H. J. Zeft,et al.  Myocardial infarction following coronary surgery: Vectorcardiographic assessment , 1973 .