Intraoperative retrograde balloon-catheter dilatation to augment myocardial revascularization.
When bypass graft surgery is planned, it is appreciated that sequential coronary artery stenoses often entrap the origins of arterial branches that have a significant, but subgraftable, diameter. These branches are routinely not perfused by saphenous vein grafts implanted beyond the second lesion. Data are presented on improving perfusion of such branches in 26 patients by the technique of retrograde intraoperative balloon-catheter dilatation. During coronary artery surgery, specially designed angioplasty catheters, 2 to 3 mm in diameter, were introduced through the coronary arteriotomy and passed retrogradely across the distal lesion. Balloon inflation was performed two to four times at 4 to 7 atm. Lesion size was assessed before and after angioplasty with the use of graduated coronary probes. Probe-determined lesion diameter increased from 1.1 +/- 0.4 to 2.0 +/- 0.4 mm (percent increase, 109 +/- 8). In selected patients, intraoperative balloon-catheter dilatation is a promising technique adjunctive to coronary surgery. Clinical significance and long-term effectiveness of this procedure require further evaluation.
D000368:Aged; D000800:Angioplasty, Balloon / Q000009:adverse effects / Q000379:methods*; D017023:Coronary Angiography; D001026:Coronary Artery Bypass; D003327:Coronary Disease / Q000000981:diagnostic imaging / Q000601:surgery* / Q000628:therapy; D006801:Humans; D007432:Intraoperative Period; D008297:Male; D008875:Middle Aged