Traitement chirurgical de l'infarctus et de ses complications à la phase aiguë

Since the advent of the thrombolytic therapy, the indications for surgical treatment of non complicated myocardial infarction have changed. Previously, early reperfusion of the acute coronary occlusion was a surgical procedure; some studies showed the interest of such early revascularisation surgery, with satisfactory results. Today, other less invasive methods such as thrombolytic therapy or percutaneous angioplasty have supplanted surgery. Nevertheless, surgery remains an additional solution, as a complement of the other techniques. At present, surgery is indicated in acute myocardial infarction only in case of failure or complications of the other methods, and in case of myocardial infarction complicated by a cardiogenic shock or mechanical complications. Advances in operative techniques, myocardial protection and postoperative care allow having satisfactory results despite the poor prognosis of these complications.