Læknaneminn - 01.03.1981, Blaðsíða 26
ar þegar árangur er ræddur. Meginniðurstaða Phill-
ips og félaga er sú að' hættur slíkra aðgerða séu ekki
meiri en áformaöra kransæðaaðgerða sé vissum skil-
yrðum fylgt (aðgerðadauði 1,3% síðlát 2,7%). De-
Wood og félagar komast að svipaðri niðurstöðu
varðandi áhættuna. Jafnframt telja þeir sig hafa
sýnt fram á að sjúklingum sem eru skornir reiði bet-
ur af en hinum, hvort sem litiö er til styttri eða
lengri tíma (5,8% vs 11,5% og 11,7% vs 20,5%).
Niðurstöður þeirra hafa sætt nokkurri gagnrýni en
þrátt fyrir það eru sérfræðingar sammála um að
þessar niðurstöður séu mjög athyglisverðar og frek-
ari rannsóknir nauðsynlegar.
Höfundur þakkar Þórði Harðarsyni yfirlœkni fyrir
lestur handrits og vinsamlegar ábendingar.
HEIMILDIR:
1 H. D. Mclntosh og J. A. Garcia: The first decade of
aortoeoronary bypass grafting. Circulation 57-3:405-431.
March 1978.
2 Council on scientific affairs: Indications for aortocoron-
ary bypass surgery. JAMA 242.24:2709-11. Dec. 1979.
3 Braunwald, E.: -oronary artery surgery a tthe crossroads.
N Engl J. Med 297.12:661-3. Sept. 1977.
4 oronary artery bypass surgery-Indications and limitations.
Editorial. The Lancet. Sept. 1980.511-513.
5 F. Loop: Letter. J Thor ard Surg. 64(3) :510. Okt. 1972.
6 R. G. Favaloro et al: Acute coronary insufficiency: Sur-
gical treatment by the saphenous vein graft technique.
Am J Cardiol 28:598. 1971.
7 G. K. Danielson: Letter. J Thor Card Surg 64(3) :510.
Oct. 1972.
8 R. Pifarré: Letter. J Tlior Card Surg. 64(3) :511. Okt.
1972.
9 E. J. Zerbini: Letter. J Thor Card Surg. 64(3) :512. Okt.
1972.
10 R. G. Favaloro: Letter. J Thor Card Surg. 64(3) :512.
Okt. 1972.
11 R. Berg et al: Acute myocardial infarct, a surgical emer-
gency. J Thor Card Surg. 70:432. 1975.
13 P. R. Maroko, B. E. Sobel, E. Braunwald et al: Factors
influencing infarct size following experimental coronary
artery occlusion. Circulation. 43:67. 1971.
14 J. L. Cox et al: The ischemic zone surrounding acute
myocardial infarction: its morphology as detected by de-
hydrogenase staining. Am Heart J: 76:650. 1978.
C. Harnaryan et al: Quantitative study of infarcted myo-
cardium in cardiogenic shock. Br Heart .1. 32:728-732.
1970.
S. J. Phillips et al: Emergency coronary artery revas-
cularization: A possible therapy for acute myocardial in-
farction. Circulation. 60(2) :241-246. 1979.
Maroko et al: Favorable effects of hyaluronidas on ECG
evidence of necrosis in patients with acute myocardial in-
farction. N Engl J Med. 296:898. 1977.
R. A. KJoner, E. Braunwald, P. R. Maroko: Long term
preservation of ischemic myocardium in the dog by hya-
luronides. Circulation. 58:220. 1978.
W. E. Shell, B. E. Sobel: Protection of jeopardized is-
chemic myocardium by reduction of ventricular afterload.
N Engl J Med. 291:481. 1974.
H. K. Gold et al: Propranolol-induced reduction of signs
of ischemic injury during acute myocardial infarction.
Am J Cardiol. 38:689. 1976.
F. A. Levine et al: Managemen of acute myocardial is-
chemia with intraaortic balloon pumping and coronary
bypass surgery. Circulation. 58:(suppl. I) :I-69. 1978.
A. Montoya et al: Hemorrhagic infarct following myo-
cardial revascularization. J Thor Card Surg 75:206. 1978.
R. J. Capone, A. S. Most: Myocardial hemorrhage after
coronary reperfusion in pigs. Am J Cardiol. 41:259. 1978.
B. H. Buckley, G. M. Hutchins: Myocardial consequences
of coronary artery bypass surgery: the paradox of ne-
crosis in areas of revascularization. Circulation. 56:906.
1977.
M. A. DeWood et al: Medical and surgical management
of myocardial infarction. Am .1 Cardiol. 44:1356-64. Dec.
1979.
L. H. Cohn et al: Aorto-coronary bypass for acute coron-
ary occlusion J Thor Card Surg. 64(4) :503-509. 1972.
J. A. Mantle et al: Emergency revascularization for acute
myocardial infarctio: An unproved experimental app-
roach. Am J Cardiol. 44:1407-9. 1979.
R. Roberts, B. E. Sobel: Coronary revascularization dur-
ing evolving myocardial infarction-the need for caution.
Circulation. 50:867-9. 1974.
H. D. Mclntosh, R. A. Buccino: Emergency coronary
artery revascularization of patients with acute myocardial
infarction; You can - But should you? Circulation. 60
(2):247-50. 1979.
Sigurður B. Þorsteinsson, Þórður Harðarson, Sigurður
Samúelsson: 94 sjúklingar með kransæðastíflu á lyflækn-
ingadeild Landspítalans 1. 1. 1969 - 1. 4. 1970. Lækna-
blaðið.
Sigurður Guðmundsson og Þórður Harðarson: Flutning-
ur sjúklinga með bráða kransæðastíflu á Borgarspítalann
1972-1975. Læknablaðið 65.1:11-21. Mars 1979.
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
24
LÆKNANEMINN