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A New Application of Counterpulsation: Safer Laparotomy After Recent Myocardial Infarction

A New Application of Counterpulsation: Safer Laparotomy After Recent Myocardial Infarction Abstract A 56-year-old man suffered severe gastrointestinal tract bleeding five days following an anterior myocardial infarction. Nonoperative treatment consisting of gastric lavage, selective angiographic procedures on the gastric arteries with intra-arterial vasopressin injection (Pitressin), and massive blood replacement over a five-day period failed to halt hemorrhage. Institution of intra-aortic balloon pumping reversed the patient's hemodynamic deterioration and made possible a definitive operation. The successful outcome in this patient suggests that counterpulsation may play a useful role in lowering the formidable surgical mortality observed in patients with acute myocardial injury who require emergency noncardiac operations. References 1. Arkins R, Smessaert AA, Hicks RR: Mortality and morbidity in surgical patients with coronary artery disease . JAMA 190:485-488, 1964.Crossref 2. Knapp RB, Topkins JJ, Artusio JF Jr: The cerebrovascular accident and coronary occlusion in anesthesia . JAMA 182:332-334, 1962.Crossref 3. Tarhan S, Moffitt EA, Taylor WF, et al: Myocardial infarction after general anesthesia . JAMA 220:1451-1455, 1972.Crossref 4. Topkins MJ, Artusio JF: Myocardial infarction and surgery: A five year study . Anesth Analg 43:716-720, 1964.Crossref 5. Chvasta TE, Cooke AR: The effect of several ulcerogenic drugs on the canine gastric mucosal barrier . J Lab Clin Med 79:302-315, 1966. 6. Rothermich NO: An extended study of indomethacin . JAMA 195:123-128, 1966. 7. Lichstein E, Liu H, Gupta P: Pericarditis complicating acute myocardial infarction: Incidence of complications and significance of electrocardiogram on admission . Am Heart J 87:246-242, 1974.Crossref 8. Thadani U, Chopra MP, Aber CP, et al: Pericarditis after acute myocardial infarction . Br Med J 2:135-137, 1971.Crossref 9. Conn HO, Ramsby GR, Storer EH: Selective intra-arterial vasopressin in the treatment of upper gastrointestinal hemorrhage . Gastroenterology 63:634-645, 1972. 10. Eisenberg H, Laufer I, Skillman JJ: Arteriographic diagnosis and management of suspected colonic diverticular hemorrhage . Gastroenterology 64:1091-1100, 1973. 11. Beller BM, Trevino A, Urban E: Pitressin-induced myocardial injury and depression in a young woman . Am J Med 51:675-679, 1971.Crossref 12. Mueller H, Ayres SM, Giannelli S, et al: Effect of isoproterenol, l-norepinephrine and intra-aortic counterpulsation on hemodynamics and myocardial metabolism in shock following myocardial infarction . Circulation 45:335-351, 1972.Crossref 13. Gill CC, Wechsler AS, Newman GE, et al: Augmentation and redistribution of myocardial blood flow during acute ischemia by intraaortic balloon pumping . Ann Thorac Surg 16:445-453, 1973.Crossref 14. Kantrowitz A, Tjønneland S, Krakauer JS, et al: Mechanical intraaortic cardiac assistance in cardiogenic shock . Arch Surg 97:1000-1004, 1968.Crossref 15. Dunkman WB, Leinbach RC, Buckley MJ, et al: Clinical and hemodynamic results of intra-aortic balloon pumping and surgery for cardiogenic shock . Circulation 46:465-477, 1972.Crossref 16. Gold HK, Leinbach RC, Saunders CA, et al: Intra-aortic balloon pumping for ventricular septal defect or mitral regurgitations complicating acute myocardial infarction . Circulation 47:1191-1196, 1973.Crossref 17. Mundth ED, Buckley MJ, DeSanctis RW: Surgical treatment of ventricular irritability . J Thorac Cardiovasc Surg 66:943-951, 1973. 18. Buckley MJ, Craver JM, Gold HK, et al: Intra-aortic balloon pump assist for cardiogenic shock after cardiopulmonary bypass . Circulation 48 ( (suppl 3) ):III-90-III-94, 1973.Crossref 19. Gold HK, Leinbach RC, Saunders CA, et al: Intra-aortic balloon pumping for control of recurrent myocardial ischemia . Circulation 47:1197-1203, 1973.Crossref 20. Weintraub RM, Voukydis PC, Aroesty JM, et al: Treatment of preinfarction angina with intra-aortic balloon counterpulsation and surgery. Am J Cardiol, to be published. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Surgery American Medical Association

A New Application of Counterpulsation: Safer Laparotomy After Recent Myocardial Infarction

Archives of Surgery , Volume 110 (1) – Jan 1, 1975

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Publisher
American Medical Association
Copyright
Copyright © 1975 American Medical Association. All Rights Reserved.
ISSN
0004-0010
eISSN
1538-3644
DOI
10.1001/archsurg.1975.01360070116020
Publisher site
See Article on Publisher Site

Abstract

Abstract A 56-year-old man suffered severe gastrointestinal tract bleeding five days following an anterior myocardial infarction. Nonoperative treatment consisting of gastric lavage, selective angiographic procedures on the gastric arteries with intra-arterial vasopressin injection (Pitressin), and massive blood replacement over a five-day period failed to halt hemorrhage. Institution of intra-aortic balloon pumping reversed the patient's hemodynamic deterioration and made possible a definitive operation. The successful outcome in this patient suggests that counterpulsation may play a useful role in lowering the formidable surgical mortality observed in patients with acute myocardial injury who require emergency noncardiac operations. References 1. Arkins R, Smessaert AA, Hicks RR: Mortality and morbidity in surgical patients with coronary artery disease . JAMA 190:485-488, 1964.Crossref 2. Knapp RB, Topkins JJ, Artusio JF Jr: The cerebrovascular accident and coronary occlusion in anesthesia . JAMA 182:332-334, 1962.Crossref 3. Tarhan S, Moffitt EA, Taylor WF, et al: Myocardial infarction after general anesthesia . JAMA 220:1451-1455, 1972.Crossref 4. Topkins MJ, Artusio JF: Myocardial infarction and surgery: A five year study . Anesth Analg 43:716-720, 1964.Crossref 5. Chvasta TE, Cooke AR: The effect of several ulcerogenic drugs on the canine gastric mucosal barrier . J Lab Clin Med 79:302-315, 1966. 6. Rothermich NO: An extended study of indomethacin . JAMA 195:123-128, 1966. 7. Lichstein E, Liu H, Gupta P: Pericarditis complicating acute myocardial infarction: Incidence of complications and significance of electrocardiogram on admission . Am Heart J 87:246-242, 1974.Crossref 8. Thadani U, Chopra MP, Aber CP, et al: Pericarditis after acute myocardial infarction . Br Med J 2:135-137, 1971.Crossref 9. Conn HO, Ramsby GR, Storer EH: Selective intra-arterial vasopressin in the treatment of upper gastrointestinal hemorrhage . Gastroenterology 63:634-645, 1972. 10. Eisenberg H, Laufer I, Skillman JJ: Arteriographic diagnosis and management of suspected colonic diverticular hemorrhage . Gastroenterology 64:1091-1100, 1973. 11. Beller BM, Trevino A, Urban E: Pitressin-induced myocardial injury and depression in a young woman . Am J Med 51:675-679, 1971.Crossref 12. Mueller H, Ayres SM, Giannelli S, et al: Effect of isoproterenol, l-norepinephrine and intra-aortic counterpulsation on hemodynamics and myocardial metabolism in shock following myocardial infarction . Circulation 45:335-351, 1972.Crossref 13. Gill CC, Wechsler AS, Newman GE, et al: Augmentation and redistribution of myocardial blood flow during acute ischemia by intraaortic balloon pumping . Ann Thorac Surg 16:445-453, 1973.Crossref 14. Kantrowitz A, Tjønneland S, Krakauer JS, et al: Mechanical intraaortic cardiac assistance in cardiogenic shock . Arch Surg 97:1000-1004, 1968.Crossref 15. Dunkman WB, Leinbach RC, Buckley MJ, et al: Clinical and hemodynamic results of intra-aortic balloon pumping and surgery for cardiogenic shock . Circulation 46:465-477, 1972.Crossref 16. Gold HK, Leinbach RC, Saunders CA, et al: Intra-aortic balloon pumping for ventricular septal defect or mitral regurgitations complicating acute myocardial infarction . Circulation 47:1191-1196, 1973.Crossref 17. Mundth ED, Buckley MJ, DeSanctis RW: Surgical treatment of ventricular irritability . J Thorac Cardiovasc Surg 66:943-951, 1973. 18. Buckley MJ, Craver JM, Gold HK, et al: Intra-aortic balloon pump assist for cardiogenic shock after cardiopulmonary bypass . Circulation 48 ( (suppl 3) ):III-90-III-94, 1973.Crossref 19. Gold HK, Leinbach RC, Saunders CA, et al: Intra-aortic balloon pumping for control of recurrent myocardial ischemia . Circulation 47:1197-1203, 1973.Crossref 20. Weintraub RM, Voukydis PC, Aroesty JM, et al: Treatment of preinfarction angina with intra-aortic balloon counterpulsation and surgery. Am J Cardiol, to be published.

Journal

Archives of SurgeryAmerican Medical Association

Published: Jan 1, 1975

References