PTCA of the left main stem following protective coronary artery bypass grafting

ArticleinEuropean Journal of Cardio-Thoracic Surgery 5(6):326-9 · February 1991with3 Reads
Impact Factor: 3.30 · DOI: 10.1016/1010-7940(91)90044-K · Source: PubMed


    Percutaneous transluminal coronary angioplasty (PTCA) was performed in14 patients with significant left main stem stenosis
    following protectivecoronary artery bypass grafting (CABG). The procedure was successful in13/14 patients (93%), achieving
    a decrease in mean diameter stenosis from74% +/- 7% to 31% +/- 12% (P less than 0.01). Accordingly, the absolutestenosis diameter
    increased from 0.9 mm +/- 0.3 mm to 2.4 mm +/- 0.5 mm (Pless than 0.01). Dissection of the left main stem artery and a transientsignificant
    fall of blood pressure each occurred in one patient. No otherserious complications were noted. Eight of 13 patients (62%)
    withsuccessful PTCA underwent control angiography. Restenosis had occurred in 3of 8 patients (38%) with total occlusion of
    the left main stem in 1patient. All bypass grafts were found to be patent at follow-up. Clinicalevaluation in all 14 patients
    revealed no serious events (death, myocardialinfarction, repeat revascularization procedure) during a mean follow-upperiod
    of 27 months (range 6-39 months). PTCA of the left main stemfollowing CABG can be considered a relatively safe and effective
    procedurewith a marked restenosis-rate but beyond that, an uncomplicated long-termfollow-up.