Jornal Vascular Brasileiro
https://www.jvascbras.org/article/doi/10.1590/jvb.2013.059
Jornal Vascular Brasileiro
Original Article

Acute myocardial infarctation in patients with critical ischemia underwent lower limb revascularization

Infarto agudo do miocardio em pacientes portadores de isquemia critica submetidos a revascularizacao de membros inferiores

Esdras Marques Lins; Jose Wellington Barros; Fernanda Appolonio; Eduardo Anacleto; Eduardo Cavalcanti Lima

http://dx.doi.org/10.1590/jvb.2013.059 J Vasc Bras, vol.12, n4, p.284-288, 2013
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Abstract

BACKGROUND: Atherosclerosis is the main cause of peripheral artery occlusive disease (PAOD) of the lower limbs. Patients with PAOD often also have obstructive atherosclerosis in other arterial sites, mainly the coronary arteries. This means that patients who undergo infrainguinal bypass to treat critical ischemia have a higher risk of AMI. There are, however, few reports in the literature that have assessed this risk properly. OBJECTIVE: The aim of this study was to determine the incidence of acute myocardial infarction in patients who underwent infrainguinal bypass to treat critical ischemia of the lower limbs caused by PAOD. MATERIAL AND METHODS: A total of 64 patients who underwent 82 infrainguinal bypass operations, from February 2011 to July 2012 were studied. All patients had electrocardiograms and troponin I blood assays during the postoperative period (within 72 hours). RESULTS: There were abnormal ECG findings and elevated blood troponin I levels suggestive of AMI in five (6%) of the 82 operations performed. All five had conventional surgery. The incidence of AMI as a proportion of the 52 conventional surgery cases was 9.6%. Two patients died. CONCLUSION: There was a 6% AMI incidence among patients who underwent infrainguinal bypass due to PAOD. Considering only cases operated using conventional surgery, the incidence of AMI was 9.6%.

Keywords

peripheral arterial disease, myocardial infarction, postoperative period

Resumo

CONTEXTO: A doença arterial obstrutiva periférica (DAOP) afeta os membros inferiores (MMII) e tem como principal causa a aterosclerose. Por se tratar de uma doença sistêmica, é frequente que a aterosclerose cause o envolvimento simultâneo de outros sítios arteriais, especialmente das artérias coronárias. Desta forma, os pacientes submetidos a cirurgia de reconstrução arterial periférica, devido a isquemia crítica dos MMII, apresentam maior chance de infarto agudo do miocárdico (IAM). Apesar disso, há na literatura poucos relatos que avaliem a prevalência do IAM adequadamente neste grupo de pacientes. OBJETIVO: Avaliar incidência do infarto agudo do miocárdio no pós-operatório imediato de pacientes submetidos à revascularização de MMII devido a DAOP. MATERIAL E MÉTODOS: Foram avaliados 64 pacientes portadores de DAOP submetidos a 82 cirurgias de revascularização arterial dos MMII, no período de fevereiro de 2011 a julho de 2012. Os pacientes foram submetidos no pós-operatório imediato (até 72 horas) a eletrocardiograma (ECG) e dosagem sanguínea de troponina I cardíaca. RESULTADOS: Considerando as 82 cirurgias realizadas, em cinco (6%) casos, foram encontradas alterações no ECG e elevação sanguínea da troponina I cardíaca compatíveis com infarto agudo do miocárdio. Considerando apenas as 52 cirurgias feitas por técnica convencional, a incidência de IAM foi de 9,6%. Dois pacientes evoluíram ao óbito. CONCLUSÃO: No presente estudo, a incidência do infarto agudo do miocárdio nos pacientes submetidos à revascularização arterial de membros inferiores por DAOP foi de 6%. Considerando apenas as cirurgias feitas por técnica convencional, a incidência de IAM foi de 9,6%.

Palavras-chave

doenca arterial periferica, infarto do miocardio, periodo pos-operatorio

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