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Coronary Reperfusion: Medical, Surgical, or Not at All?
K. Lance Gould, MD
JAMA. 1982;248(11):1362-1363.
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| Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings. |
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In this issue of The Journal (p 1325), Phillips et al report improved ventricular function and survival in patients undergoing immediate bypass surgery for acute myocardial infarction, findings similar to their earlier observations in 1979.1 Berg2 and DeWood et al3 from Spokane, Wash, initially reported improved survival in patients who had undergone coronary bypass surgery as compared with medically treated patients with acute myocardial infarction. These articles demonstrate both the promise and the problems of innovative, aggressive intervention to reperfuse jeopardized myocardium, demonstrated by most,4-7 but not all,8-10 experimental studies to be beneficial.
On the positive side, Phillips et al have set aside arbitrary assumptions about a fixed, maximum duration of chest pain beyond which salvage is considered infeasible. Their decision for surgical intervention depended on clinical evidence of ongoing ischemia that indicated remaining viable myocardium as compared with depending on rigid time periods based
. . . [Full Text PDF of this Article]
Author Affiliations
Department of Internal Medicine Division of Cardiology Positron Diagnostic and Research Center University of Texas Health Science Center Houston
Footnotes
Address editorial communications to the Editor, 535 N Dearborn St, Chicago, IL 60610.
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