78 The Annals of Thoracic Surgery Vol 35 No 1 January 1983 Although Dr. Walker seems rather reluctant to en- dorse early surgical intervention I would, again, stress the necessity for early operation after success- ful thrombolysis. As a surgeon, I am frightened by the generally high-grade underlying stenosis in which complete occlusion by secondary thrombosis has already been proven, and I do not dare wait longer than absolutely necessary to perform surgical revascularization. My colleagues and I are certainly aware of the Spokane group, which has done important work in the field of primary surgical treatment of acute MI. Unfortunately, the results in our own series of patients having primary surgical revascularization are not as good. One major question in such series is certainly the definition of MI. For this reason, it would be interesting to know how many patients in the large Spokane series had proven acute occlusion with an enzymatically relevant infarction. It has been rather difficult for us to convince our cardiologists to perform emergency catheterization for immediate operation in patients admitted to the hospital with acute MI. Our medical colleagues have often had the feeling of doing the so-called odd job in the background while the spotlight remained on the surgeon. However, intracoronary thrombolysis has altered these positions: The cardiologist interrupts critical ischemia in the heart by performing medical revascularization, and credit for the immediate success remains with him or her. Nevertheless, the ulti- mate result depends on the efforts of both the cardiologist and the surgeon. Erratum In the article ”Carinal Reconstruction” by Hermes C. Grillo, M.D. (Ann Thorac Surg 34:356, 1982), the term adenocystic carcinoma ap- pears in several places instead of the correct term, adenoid cystic carcinoma. This error was in- troduced during the editorial process and was not caught before the issue appeared in print. The Editor takes full responsibility and sincerely hopes that the error will not detract from the excellence of Dr. Grillo’s article.

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78 The Annals of Thoracic Surgery Vol 35 No 1 January 1983

Although Dr. Walker seems rather reluctant to en- dorse early surgical intervention I would, again, stress the necessity for early operation after success- ful thrombolysis. As a surgeon, I am frightened by the generally high-grade underlying stenosis in which complete occlusion by secondary thrombosis has already been proven, and I do not dare wait longer than absolutely necessary to perform surgical revascularization.

My colleagues and I are certainly aware of the Spokane group, which has done important work in the field of primary surgical treatment of acute MI. Unfortunately, the results in our own series of patients having primary surgical revascularization are not as good. One major question in such series is certainly the definition of MI. For this reason, it

would be interesting to know how many patients in the large Spokane series had proven acute occlusion with an enzymatically relevant infarction.

It has been rather difficult for us to convince our cardiologists to perform emergency catheterization for immediate operation in patients admitted to the hospital with acute MI. Our medical colleagues have often had the feeling of doing the so-called odd job in the background while the spotlight remained on the surgeon. However, intracoronary thrombolysis has altered these positions: The cardiologist interrupts critical ischemia in the heart by performing medical revascularization, and credit for the immediate success remains with him or her. Nevertheless, the ulti- mate result depends on the efforts of both the cardiologist and the surgeon.

Erratum In the article ”Carinal Reconstruction” by Hermes C. Grillo, M.D. (Ann Thorac Surg 34:356, 1982), the term adenocystic carcinoma ap- pears in several places instead of the correct term, adenoid cystic carcinoma. This error was in- troduced during the editorial process and was not caught before the issue appeared in print. The Editor takes full responsibility and sincerely hopes that the error will not detract from the excellence of Dr. Grillo’s article.