{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,6]],"date-time":"2025-11-06T12:02:39Z","timestamp":1762430559414},"reference-count":0,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circulation"],"published-print":{"date-parts":[[1990,10]]},"abstract":"<jats:p>This study was performed to define the in-hospital and late clinical outcome at 5 years in 430 patients who had a failed elective percutaneous transluminal coronary angioplasty (PTCA) and underwent coronary artery bypass graft (CABG) surgery during their hospitalization. This group comprised 5.9% of 7,246 patients undergoing elective PTCA. CABG surgery was performed in 346 patients with ongoing myocardial ischemia (80.5%) and in 84 patients without ischemia (19.5%). Their mean age was 56 +\/- 9 years, and 76.3% were male. One-vessel disease was present in 72.3%, and the mean left ventricular ejection fraction was 59 +\/- 11%. Overall, 1.9 +\/- 0.9 bypass grafts were placed. There was increased use of the internal thoracic artery in the nonischemic group. A new nonfatal postprocedural Q wave myocardial infarction occurred in 21.2% and occurred more frequently in the ischemic (25.4%) than in the nonischemic (3.6%) group (p less than 0.0001). There were six in-hospital deaths (1.4%), an incidence that did not differ between the two groups. Follow-up was 99.8% complete. There were 25 deaths (93.2 +\/- 1.5%, 5-year survival), including 16 of cardiac cause (95.3 +\/- 1.3%, 5-year cardiac survival). Q wave myocardial infarction occurred in 111 patients (91 in-hospital), and freedom from cardiac death or nonfatal myocardial infarction at 5 years was 71 +\/- 3%. In the group going to CABG surgery with ongoing ischemia, the 5-year cardiac survival was 94.9 +\/- 1.6%, and in the group without ischemia, the corresponding survival was 96.2 +\/- 2.2%. By multivariate analysis, the presence of preoperative myocardial ischemia, pre-PTCA diameter stenosis less than 90%, and the presence of multiple-vessel disease correlated with the occurrence of cardiac death or nonfatal myocardial infarction at 5 years. At this large-volume center with extensive PTCA operator and surgical experience, the excellent survival and low event rates over 5 years support the concept that despite the failed elective PTCA procedure, there was little effect on long-term survival provided the patient underwent prompt successful surgical revascularization.<\/jats:p>","DOI":"10.1161\/01.cir.82.4.1203","type":"journal-article","created":{"date-parts":[[2011,6,17]],"date-time":"2011-06-17T20:29:13Z","timestamp":1308342553000},"page":"1203-1213","update-policy":"http:\/\/dx.doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":72,"title":["Failed elective percutaneous transluminal coronary angioplasty requiring coronary artery bypass surgery. In-hospital and late clinical outcome at 5 years."],"prefix":"10.1161","volume":"82","author":[{"given":"J D","family":"Talley","sequence":"first","affiliation":[{"name":"Andreas Gruentzig Cardiovascular Center, Department of Medicine, Emory University School of Medicine, Atlanta, GA 30322."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"W S","family":"Weintraub","sequence":"additional","affiliation":[{"name":"Andreas Gruentzig Cardiovascular Center, Department of Medicine, Emory University School of Medicine, Atlanta, GA 30322."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G S","family":"Roubin","sequence":"additional","affiliation":[{"name":"Andreas Gruentzig Cardiovascular Center, Department of Medicine, Emory University School of Medicine, Atlanta, GA 30322."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"suffix":"Jr","given":"J S","family":"Douglas","sequence":"additional","affiliation":[{"name":"Andreas Gruentzig Cardiovascular Center, Department of Medicine, Emory University School of Medicine, Atlanta, GA 30322."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"H V","family":"Anderson","sequence":"additional","affiliation":[{"name":"Andreas Gruentzig Cardiovascular Center, Department of Medicine, Emory University School of Medicine, Atlanta, GA 30322."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"E L","family":"Jones","sequence":"additional","affiliation":[{"name":"Andreas Gruentzig Cardiovascular Center, Department of Medicine, Emory University School of Medicine, Atlanta, GA 30322."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"D C","family":"Morris","sequence":"additional","affiliation":[{"name":"Andreas Gruentzig Cardiovascular Center, Department of Medicine, Emory University School of Medicine, Atlanta, GA 30322."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"H A","family":"Liberman","sequence":"additional","affiliation":[{"name":"Andreas Gruentzig Cardiovascular Center, Department of Medicine, Emory University School of Medicine, Atlanta, GA 30322."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J M","family":"Craver","sequence":"additional","affiliation":[{"name":"Andreas Gruentzig Cardiovascular Center, Department of Medicine, Emory University School of Medicine, Atlanta, GA 30322."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R A","family":"Guyton","sequence":"additional","affiliation":[{"name":"Andreas Gruentzig Cardiovascular Center, Department of Medicine, Emory University School of Medicine, Atlanta, GA 30322."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","container-title":["Circulation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/pdf\/10.1161\/01.CIR.82.4.1203","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,12]],"date-time":"2024-05-12T15:45:12Z","timestamp":1715528712000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/01.CIR.82.4.1203"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1990,10]]},"references-count":0,"journal-issue":{"issue":"4","published-print":{"date-parts":[[1990,10]]}},"alternative-id":["10.1161\/01.CIR.82.4.1203"],"URL":"https:\/\/doi.org\/10.1161\/01.cir.82.4.1203","relation":{},"ISSN":["0009-7322","1524-4539"],"issn-type":[{"value":"0009-7322","type":"print"},{"value":"1524-4539","type":"electronic"}],"subject":[],"published":{"date-parts":[[1990,10]]},"assertion":[{"value":"1990-10-01","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}