INTRAAORTIC BALLOON PUMPING AS ADJUNCTIVE THERAPY TO RESCUE CORONARY ANGIOPLASTY AFTER FAILED THROMBOLYSIS IN ANTERIOR WALL ACUTE MYOCARDIAL-INFARCTION
M. Ishihara et al., INTRAAORTIC BALLOON PUMPING AS ADJUNCTIVE THERAPY TO RESCUE CORONARY ANGIOPLASTY AFTER FAILED THROMBOLYSIS IN ANTERIOR WALL ACUTE MYOCARDIAL-INFARCTION, The American journal of cardiology, 76(1), 1995, pp. 73-75
Although thrombolytic therapy is widely used to restore antegrade coro
nary blood flow, greater than or equal to 25% of the infarct-related c
oronary arteries fail to recanalize after thrombolytic therapy.(1) Res
cue coronary angioplasty achieves coronary artery patency in a large p
roportion of patients in whom coronary thrombolysis has failed, but it
is associated with a high reocclusion rate and recovery of left ventr
icular function is minimal.(2,3) The left anterior descending coronary
artery supplies the largest amount of the ventricular myocardium, and
anterior myocardial infarction is associated with a higher mortality
rate than myocardial infarction in different locations. Aggressive for
ms of management of patients with anterior myocardial infarction have
been advocated. Intraaortic balloon pumping is the most reliable metho
d for simultaneously increasing diastolic arterial pressure, while red
ucing left ventricular load. Intraaortic balloon pumping, if performed
after rescue coronary angioplasty, might prevent reocclusion of the c
oronary artery through augmentation of coronary perfusion and enhance
recovery of left ventricular function through left ventricular unloadi
ng.(4,5) To test this hypothesis, we performed intraaortic balloon pum
ping in patients with acute anterior myocardial infarction who underwe
nt rescue coronary angioplasty after unsuccessful thrombolysis.