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At least 55 records · Page 3Linked to original sources
PubMed1977

Arterial counterpulsation in the management of ischaemic heart disease.

Arterial counterpulsation is a major advance in the treatment of myocardial ischaemia in association with myocardial infarction. Counterpulsation is based on sound physiological principles and can be expected to limit ischaemia and necrosis when applied within the first 12 to 24 hours of infarction. It has been used in massive infarction with cardiogenic shock, and in threatening infarction. Good results at both ends of a clinical spectrum suggest an important role throughout the spectrum. Studies in progress are attempting to define this role.

Aorta↗
PubMed1979

Arterial counterpulsation in severe refractory heart failure complicating acute myocardial infarction.

The role of arterial counterpulsation was sought in 100 patients with severe refractory cardiac failure complicating myocardial infarction. Seventy-four were in shock and 26 were not. Average duration of counterpulsation was 7.0 days. Hospital survival was 34 per cent (25/74) in shock (predicted less than 10%) and 65 per cent in patients who were not in shock (predicted less than 50%). Survival at 4 years was 10 +/- 4 per cent in shock and 37 +/- 11 per cent in patients not in shock; functional status was class 1 or 2 in 5 of 9 patients in shock and in 8 of 12 survivors not in shock. Results were best when counterpulsation was started early after onset of symptoms, when ischaemic pain was still present, or when a mechanical defect was corrected surgically. Early coronary artery bypass surgery performed alone in 9 patients did not influence survival or functional status. Complications of counterpulsation occurred in 17 patients in shock and in 2 patients not in shock, all but 6 on the first day; none directly caused death. Counterpulsation is an effective and safe adjunct to medical treatment of complicated infarction provided the intervention is prompt.

Adult↗
PubMed1979

[Aortocoronary bypass for the threatened spread of acute myocardial infarction].

21 patients with unstable angina in the acute myocardial infarction period were treated by early surgery, on average on the 3th day after infarction. Resistance to medical therapy given in the coronary care unit, associating modern pharmacological agents and circulatory assistance, on the one hand, and the presence of lesions on the coronary arteries accessible to surgery on the other, were the surgical indications. The absence of operative mortality and of electrical changes after operation seem to be related to the many advances made in the various stages of the medico-surgical management. These results suggest that revascularisation surgery with an acceptable risk may be proposed to patients with unstable angina after a recent myocardial infarction.

Acute Disease↗
PubMed1977

Mechanical combined heart supporting system for prevention of irreversible ventricular fibrillation after experimental cardiogenic shock.

To determine whether haemodynamic effective support of the failing heart can prevent spontaneous irreversible ventricular fibrillation (IVF) after experimental cardiogenic shock, 63 open chest dogs were assigned randomly into four groups--two control groups (combined heart failure--CHF) and two MCHSS-treated (combined heart failure and non-pulsatile bypass with intraaortic counterpulsation). The CHF was produced by occlusion of the anterior descending coronary artery (group I) or the left circumflex coronary artery (group II) and by an artificial shunt between the pulmonary artery and right atrium. IVF were observed in 10 out of 22 control dogs (group I) and im 17 out of 21 control dogs (group II). In the 20 dogs with the CHF (10 animals in each group) the MCHSS was performed in the course of two hours. During the heart support no IVF were observed in any of the dogs. The difference between the incidence of IVF in the control and treated animals is statistically significant (Chi square = 21.9767 greater than Chi square 0.005).

Animals↗