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Emergency Surgery Critical After Failed Angioplasty

Delaying it may put patients at risk, study finds

WEDNESDAY, Nov. 12, 2003 (HealthDayNews) -- An estimated one in four patients are at increased risk of death or harm if emergency heart surgery is delayed after they have failed angioplasty.

So claims a study presented Nov. 12 at the American Heart Association's annaul conference in Orlando, Fla.

Canadian and American researchers reviewed 6,582 angioplasties performed in the University Health Network in Toronto from 1996 to 2000.

Before reviewing the cases, the researchers developed a set of criteria, based on published data, that had been associated with poor outcomes after failed angioplasty. These included hemodynamic instability, perforation of the artery or heart, or sustained lack of blood flow to the heart.

Of the 6,5582 angioplasty cases, 45 (0.7 percent) patients were referred for emergency heart surgery after failed angioplasty.

"Of those 45 cases, the prespecified criteria identified 11 patients who would have been at high likelihood of harm with additional delays to surgery," researcher Dr. Mat Lotfi of the Duke University Clinical Research Institute, says in a prepared statement.

"Therefore, the number of patients potentially harmed by delays to emergency surgery we estimated to be approximately one to two patients per 1,000 angioplasties (25 percent of 0.7 per cent)," Lotfi says.

There were two deaths (4.4 percent) within the group of 45 patients who had emergency heart surgery. Two other patients were rushed to the operating room immediately and two more were too unstable to be transferred. That suggests that, had there been any delays to surgery in these cases, there would have been an additional four deaths, which would have resulted in a death rate of 13.3 percent.

Of the 45 patients, 25 had emergency heart surgery that started within four hours, while 15 waited at least 12 hours.

More information

Here's where you can learn more about angioplasty.

SOURCE: Duke University, news release, Nov. 12, 2003
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