Percutaneous transluminal angioplasty in patients greater than or equal to 5 years after their last coronary bypass graft surgery.
Angioplasty (PTCA) was successfully performed in 257 of 304 patients (85%) greater than or equal to 5 years after their last bypass surgery. A lesion was successfully dilated in 496 of 566 vessels attempted (88%): 332/386 coronary arteries (86%) and 164/180 vein grafts (91%). Significant complications included: 8 (2.6%) mortalities, 4 (1.3%) emergency surgeries, 13 (4.3%) Q-wave myocardial infarctions, and 14 (4.6%) distal embolizations. Distal embolization occurred in 13/180 (7%) vein graft lesions dilated and usually resulted in a non-Q-wave infarction (4/13 distal embolizations). A second PTCA was performed on 89 (35%) patients: 44% of them had lesion recurrence; 20% a new lesion requiring dilatation; and 30% both recurrence and new lesion. Follow-up (mean 3.7 years) revealed 78% of patients having an improved anginal status, and 58% no angina. The cumulative probability of survival at 60 months was 88 +/- 3%. Angioplasty can be effectively employed in patients greater than or equal to 5 years remote from their last bypass surgery in native arteries or saphenous vein grafts with good procedural and long-term success. Vein graft age inherently does not appear to be a contraindication to angioplasty.
Dorros
G
G
Department of Cardiology, St. Luke's Medical Center, Milwaukee, Wisconsin.
Lewin
R F
RF
Mathiak
L
L
D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects / Q000401:mortality / Q000592:standards*; D001026:Coronary Artery Bypass; D003327:Coronary Disease / Q000145:classification / Q000601:surgery; D003328:Coronary Thrombosis / Q000453:epidemiology / Q000209:etiology; D003329:Coronary Vasospasm / Q000453:epidemiology / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006083:Graft Occlusion, Vascular / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology / Q000209:etiology / Q000401:mortality; D011183:Postoperative Complications / Q000628:therapy*; D012008:Recurrence; D015996:Survival Rate