[Cardiopulmonary support in PTCA for severe coronary artery disease: its efficacy].
Percutaneous transluminal coronary angioplasty (PTCA) assisted by cardiopulmonary femorofemoral bypass was performed in 4 patients who were considered to be candidates for this technique because of their severe coronary artery diseases, including 2 with left main trunk disease, one with cardiogenic shock, and one with severe 3-vessel disease. Here we report the efficacy of cardiopulmonary support in PTCA. Case 1: An 85-year-old man with persistent unstable angina despite maximal doses of medications. Stenosis of the left anterior descending coronary artery (90%) was resolved by PTCA with cardiopulmonary bypass and intraaortic balloon pumping (IABP). Case 2: An 83-year-old man with unstable angina had high grade stenoses in the distal left main, left anterior descending and right coronary arteries. Although IABP was instituted for sustained chest discomfort and ST depression, the patient developed congestive heart failure. PTCA of the left main coronary artery with cardiopulmonary bypass was successfully performed. Case 3: A 64-year-old man with acute myocardial infarction. PTCA of the occluded left anterior descending coronary artery resulted in shock despite IABP, which was resolved by cardiopulmonary bypass with percutaneous insertion of cannulae, the technique we developed. Case 4: A 74-year-old man with unstable angina. He had a severe 3-vessel disease and a thrombus in the right coronary artery.(ABSTRACT TRUNCATED AT 250 WORDS)
Ueda
O
O
Department of Cardiology, Koga Hospital, Kurume.
Okazaki
H
H
Kohchi
K
K
Koga
N
N
Sakurai
J
J
Ohteki
H
H
Itoh
T
T
D000368:Aged; D000369:Aged, 80 and over; D000789:Angina, Unstable / Q000628:therapy*; D015906:Angioplasty, Balloon, Coronary; D002315:Cardiopulmonary Bypass; D005069:Evaluation Studies as Topic; D006801:Humans; D008875:Middle Aged; D009203:Myocardial Infarction / Q000628:therapy*