[Isolated left anterior artery disease: angiographic features and clinical evolution of patients submitted to surgical myocardial revascularization or angioplasty].
The option for revascularization and the choice of intervention in isolated left anterior descending artery disease may be controversial. We decided to study retrospectively a group of revascularized patients (PTCA or surgery), with previous isolated LAD disease, to evaluate the angiographic features of LAD lesion, its contribution to the persistence of symptoms after revascularization and also to compare the occurrence of cardiac events in the two subgroups (PTCA and surgery). We studied 87 patients (mean age 57 +/- 10 years) submitted to myocardial revascularization (68 PTCA; 19 surgery), whose clinical evolution was followed for a mean period of 49 +/- 10 months (cardiac events: death, myocardial infarction, angina, heart failure, PTCA, surgery). We evaluated in cineangiography angiographic features of LAD lesions (degree of stenosis, lesion length and diameter, ectasia, luminal irregularity, ulcerated plaque, eccentricity, thrombus, calcification, type of lesion). On comparing angiographic features, we noted coronary lesions were longer in operated patients (p < 0.05) and a tendency for more complex lesions in this group (p = 0.08). After revascularization, 65% of PTCA patients and 26% of operated patients maintained angina (p < 0.01). The frequency of events was significantly higher in patients submitted to PTCA (84%) due to the greater occurrence of angina (65%). Sixteen percent PTCA were redilated and 6% operated whereas 11% of the surgical group were reoperated, without statistical difference regarding reintervention between the two groups. In the PTCA group, the greater frequency of angina and the necessity of a new PTCA could reflect restenosis. The disappearance of angina in operated patients may reflect probable patency of coronary bypass.
Abreu
A
A
Patrício
L
L
Bernardes
L
L
Abreu
J
J
Sousa
L
L
Aranha
J
J
Cardoso
P
P
Dionísio
P
P
Ramos
J M
JM
Roquette
J
J
Antunes
A M
AM
D000368:Aged; D000790:Angiocardiography; D015906:Angioplasty, Balloon, Coronary; D002932:Cineangiography; D001026:Coronary Artery Bypass; D003327:Coronary Disease / Q000601:surgery*; D003331:Coronary Vessels / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome