[Coronary angioplasty, a privileged method of myocardial revascularization of the elderly].
Coronary angioplasty is a myocardial revascularisation technique of choice in the elderly, avoiding the need for general anesthesia as well as the complications of thoracotomy and extracorporeal circulation. Used in a continuous series of 62 patients, it provided a 79% primary success rate in this situation, where reaching the coronary artery and penetrating the stenosis may be difficult. Femoral complications (hematoma, false aneurysm) are commoner in this age group, but appear to be beneficially influenced by the replacement of heparin by ticlopidine peri-operatively. With 24 months follow-up, the proportion of patients free of any major cardiac event and NYHA classes I and II is 66%, actuarial survival rate without infarction is 76%. These results would tend to restrict the indications for bypass after the age of 75 to cases of stenosis of the left main coronary artery, failure of angioplasty or multi-vessel atheroma with a "culprit lesion" inaccessible to dilatation.
Metzger
J P
JP
Clinique Cardiologique, Hôpital Necker, Paris.
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Vacheron
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D000368:Aged; D000369:Aged, 80 and over; D000789:Angina, Unstable / Q000601:surgery; D015906:Angioplasty, Balloon, Coronary; D001026:Coronary Artery Bypass; D003327:Coronary Disease / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D009204:Myocardial Revascularization; D011446:Prospective Studies; D012086:Reoperation; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome
L'angioplastie coronaire, méthode privilégiée de revascularisation myocardique du sujet âgé.