SURGERY FOR CARDIOGENIC SHOCK

Abstract

Eleven patients were consecutively operated upon for cardiogenic shock caused by myocardial infarction. The cardiogenic shock was refractory to conventional medical therapy. All eleven patients were dependent on intra-aortic counterpulsation balloon until after surgery. Cardiac catheterisation and high-resolution coronary angiography were done approximately 24 hours after balloon insertion. Aortocoronary saphenous-vein bypass grafting, left-ventricular infarctectomy, and correction of mechanical derangements followed catheterisation by 12 hours to 6 days. All five survivors are leading useful lives 8-20 months after their surgery, four having returned to work. Criteria for the preoperative selection for surgery of patients with cardiogenic shock refractory to medical therapy are unsatisfactory. Conventional hæmodynamic data obtained preoperatively were of little use in predicting survival.