Mortality trends in cases of elective and emergency aorto-coronary bypass after percutaneous transluminal coronary angioplasty.

Between October 1977 and March 1986 82 emergency and 113 elective revascularizations (aorta-coronary bypass = ACB) were performed after complicated or unsuccessful PTCA (n = 1633). Mortality in emergency ACB was 10.9%, in elective surgery 1.2%. If permanent transmural ischemia after complicated PTCA is present, mortality was high (12.6%) and postoperative infarction rate 70%. In intermittent ischemia mortality was 5.1% and total recovery of the myocardium was 94%. Mortality in emergency ACB after PTCA was directly related to the number of diseased vessels. In single vessel disease mortality was 3.5%, in multiple vessels disease 28%.