Intracoronary streptokinase thrombolytic recanalization and subsequent surgical bypass of remaining atherosclerotic stenosis in acute myocardial infarction: Complementary combined approach effecting reduced infarct size, preventing reinfarction, and improving left ventricular function

摘要: Abstract In 48 patients with acute myocardial infarction (AMI) the acutely thrombus-occluded coronary artery was successfully recanalized nonsurgically via catheter intracoronary streptokinase (SK) infusion after a mean occlusion time of 3.1 ± 1.6 hours. all cases residual high-grade fixed atherosclerotic stenosis remained percutaneous transluminal recanalization (PTCR). Subsequent aortocoronary bypass surgery (ACBS) circumventing stenotic performed during stage (within 10 days AMI onset) in 34 and electively (longer than 14 patients. No patient died from early PTCR or ACBS intervention. There were two late post-ACBS arrhythmogenic deaths, suffered nonfatal reinfarction post several months hospital discharge, only had occasional angina pectoris, one mild heart failure. The remaining 41 completely asymptomatic throughout long-term follow-up evaluation. left ventricular (LV) segment supplied by initially occluded artery, which means SK therapy subsequently grafted, wall motion improved significantly to postoperative who underwent (from 13.6% 1.9% 40.3% 2.7%, p