Changing patterns in the surgical management of XXXX after myocardial infarction.

@entity1 @entity26 @entity1455 @entity9009
Seventeen consecutive @entity1 who underwent repair of postinfarction @entity9009 between 1975 and 1980 at the Yale-New Haven Medical Center are reported on. The most important prognostic indicator of a favorable outcome was the @entity1 's preoperative hemodynamic state. The mortality rate ranged from 83 percent for @entity1 in shock to no mortality in @entity1 with mild to moderate symptoms. There was a strong tendency for hemodynamic deterioration despite hemodynamic support with pharmacologic agents as well as intraaortic balloon pumping. Our review indicates that several @entity1 might have been saved if operation had been performed earlier. Based on this experience and that of others, a management plan is formulated, and we recommend early surgical intervention in all operable @entity1 with @entity9009 . In @entity1 with severe @entity1455 , we forego full cardiac catheterization, confirming the diagnosis by an @entity26 step-up in the pulmonary artery only. These @entity1 undergo operation on an urgent basis. No undue technical difficulties were related to early operation. At present, maximum survival of @entity1 with postinfarction @entity9009 may be accomplished by early surgical intervention in all operable cases.
