Coronary angioplasty in patients with previous surgical therapy

pp 209-215

Abstract

From december 1987 to february 1991, coronary angioplasty was performed consecutively, in 38 patients with prior coronary artery by pass surgery. These series including all the PTCA performed in these population since the beginning of our Department. Eleven patients had stable angina (28 %) and twenty seven (78 %) unstable angina; 52.30 % had previous myocardial infarction. The mean time between PTCA and the by pass surgery was 51.6 ± 44 months. The procedure was done in 60 vessels, 38 native coronary angioplasty, 16 in saphenous by pass graft and in 6 left mammary artery. Primary success was 88.3 % (53/60) per lesion and 92.1 % (35/38) per patients. Complete revascularization was obtained in 88.60/. of the cases (31/35). Initial success rate was equal in native artery 83.70/. than in mammary artery 83.3 % or saphenous graft 93.7 % (NS). No patients had in hospital death, myocardial infarction or emergency by pass surgery. Immediately post PTCA, 88.8 %. of the patients improved functional class and at a mean follow up of 11.5 ± 7.5 months, all the patients were alive, 81.8 % had improvement in angina but six patients (15.8 %) need new revascularization procedure. Conclusions: These results suggest that PTCA could be the ideal first interventional approach in patients with previous coronary by pass surgery.