title: PTCA of the left main stem following protective coronary artery bypass grafting.
abstract: Percutaneous transluminal coronary angioplasty (PTCA) was performed in 14 patients with significant left main stem stenosis following protective coronary artery bypass grafting (CABG). The procedure was successful in 13/14 patients (93%), achieving a decrease in mean diameter stenosis from 74% +/- 7% to 31% +/- 12% (P less than 0.01). Accordingly, the absolute stenosis diameter increased from 0.9 mm +/- 0.3 mm to 2.4 mm +/- 0.5 mm (P less than 0.01). Dissection of the left main stem artery and a transient significant fall of blood pressure each occurred in one patient. No other serious complications were noted. Eight of 13 patients (62%) with successful PTCA underwent control angiography. Restenosis had occurred in 3 of 8 patients (38%) with total occlusion of the left main stem in 1 patient. All bypass grafts were found to be patent at follow-up. Clinical evaluation in all 14 patients revealed no serious events (death, myocardial infarction, repeat revascularization procedure) during a mean follow-up period of 27 months (range 6-39 months). PTCA of the left main stem following CABG can be considered a relatively safe and effective procedure with a marked restenosis-rate but beyond that, an uncomplicated long-term follow-up.
authors.affiliation: Second Medical Clinic, Johannes Gutenberg University, Mainz, FRG.
authors.forename: H J
authors.initials: HJ
authors.lastname: Rupprecht
authors.forename: H
authors.initials: H
authors.lastname: Oelert
authors.forename: S
authors.initials: S
authors.lastname: Trautmann
authors.forename: T
authors.initials: T
authors.lastname: Pop
authors.forename: S
authors.initials: S
authors.lastname: Iversen
authors.forename: R
authors.initials: R
authors.lastname: Erbel
authors.forename: J
authors.initials: J
authors.lastname: Meyer
mesh_terms: D000328:Adult; D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects; D001024:Aortic Valve Stenosis / Q000601:surgery / Q000628:therapy*; D001026:Coronary Artery Bypass; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012008:Recurrence