[PTCA in patients undergoing coronary bypass surgery and its potential availability: when can PTCA be an alternative to coronary artery bypass grafting?].
The potential availability of percutaneous transluminal coronary angioplasty (PTCA) was retrospectively evaluated for the responsible lesions among grafted vessels of 149 patients who underwent coronary artery bypass grafting (CABG). The lesions suitable for PTCA were defined as discrete, segmental, subtotal and noncalcific, in proximal or middle portions of the major coronary arteries. Patients with left main trunk lesions, those with obstruction of two major coronary arteries, and those with lesions in donor arteries of jeopardized collaterals were excluded. Ninety-seven (31%) of a total of 308 grafted lesions were appropriate for PTCA. These included 38% of left anterior descending artery (LAD) lesions, 39% of left circumflex artery (CX) lesions, and 14% of right coronary artery (RCA) lesions. At least one lesion of 77 (52%) of 149 patients was suitable for PTCA. These included 66% of single vessel graft candidates, 54% of double vessel graft candidates, and 38% of triple or more vessel graft candidates. Ideal candidates for PTCA were 34 patients (23%) in whom all lesions in the grafted vessels were thought to be appropriate for PTCA, and these included 25 (LAD: 23, CX: 1, RCA: 1) of 38 single vessel graft candidates and nine (LAD + RCA: 6, LAD + CX: 2, CX + RCA: 1) of 111 multivessel graft candidates. There was no significant difference between the clinical characteristics of the patients ideally suited for PTCA and the remaining patients. Additional 25 candidates for multivessel grafting, whose lesions were appropriate for PTCA except that of the LAD, were considered limited candidates for PTCA.(ABSTRACT TRUNCATED AT 250 WORDS)
D000800:Angioplasty, Balloon; D001026:Coronary Artery Bypass; D003327:Coronary Disease / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies