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Safer Laparotomy After Recent Myocardial Infarction

Steven I. Cohen, MD; Ronald M. Weintraub, MD

Arch Surg. 1975;110(1):116-117.

Abstract
A 56-year-old man suffered severe gastrointestinal tract bleeding five days following an anterior myocardial infarction. Nonoperative treatment consisting of gastric lavage, selective angiographic procedures on the gastric arteries with intra-arterial vasopressin injection (Pitressin), and massive blood replacement over a five-day period failed to halt hemorrhage. Institution of intra-aortic balloon pumping reversed the patient's hemodynamic deterioration and made possible a definitive operation. The successful outcome in this patient suggests that counterpulsation may play a useful role in lowering the formidable surgical mortality observed in patients with acute myocardial injury who require emergency noncardiac operations.

Author Affiliations
From the Department of Surgery, Harvard Medical School and Beth Israel Hospital, Boston.

Footnotes
Accepted for publication Aug 5, 1974.

Reprint requests to Beth Israel Hospital, 330 Brookline Ave, Boston, MA 02215 (Dr. Weintraub).

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