[Importance of coronary dilatation in patients after bypass operation].

Le résumé fourni par la source

342 consecutive patients with recurrent angina pectoris were investigated 4.9 +/- 2.9 years after bypass surgery. According to the respective coronary morphology, angioplasty (PTCA) was performed in 110 patients (32%), repeat surgery in 32 (9%) and 200 patients (58%) were treated medically. Angioplasty was undertaken in 113 native coronary arteries (18 via a patent venous graft) and 29 bypass grafts. One vessel was dilated in 84 patients (76%) and more than one vessel in 26 patients (24%), giving an average of 1.3 vessels per patient. The initial success rate was 84% (120 of 142 vessels). The success rate varied from 60% in the midportion of venous grafts to 100% in the bypass protected left main stem. One patient died from complications (0.9%) and 5 patients (4.5%) suffered a myocardial infarction. Revascularisation was complete in 64 patients (58%) and remained incomplete in 40 patients. Clinical state improved in all but 7 patients and 70 patients (64%) became symptom-free. After 6 months 88 patients were clinically reevaluated. 52 patients (59%) still showed improvement in anginal status or remained symptom-free. Due to recurrent symptoms a re-angioplasty was performed on 21 patients and 6 patients had to be reoperated. In conclusion, coronary angioplasty is frequently a feasible alternative to reoperation with calculable risks in patients with recurrence of symptoms after prior bypass surgery.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.