Rodeanu M, Halon D A, Flugelman M Y, Shefer A, Merdler A, Shehadeh H, Saggie Y, Lewis B S
Harefuah. 1989 Jan 1;116(1):29-32.
Anginal syndrome may recur early of several years after coronary artery bypass surgery (CABS), and may be due to narrowing of a bypass graft, progression of pre-existing coronary artery lesions, or the appearance of new lesions. Repeat CABS is associated with considerable morbidity and mortality. We therefore performed percutaneous transluminal angioplasty (PTCA) in saphenous or internal mammary bypass grafts or native coronary arteries in 23 patients after CABS. We successfully dilated 35 of 37 lesions (95%) present in 33 of 35 vessels (94%) of 21 of 23 patients (91%). The mean vessel narrowing decreased from 86 +/- 22% to 13 +/- 19% (p less than 0.001) and in all 21 patients with angiographic evidence of success functional capacity improved. Single vein grafts were successfully dilated in 9 patients. None developed acute myocardial infarction or needed emergency surgery, but 1 had a cerebral embolism. PTCA is effective therapy for recurrent angina after CABS, and in many patients is preferable to another operation.
心绞痛综合征可能在冠状动脉搭桥手术（CABS）后的几年内早期复发，其原因可能是搭桥血管狭窄、原有冠状动脉病变进展或新病变出现。再次进行CABS会伴有相当高的发病率和死亡率。因此，我们对23例CABS术后患者的大隐静脉或乳内动脉搭桥血管或自身冠状动脉进行了经皮腔内血管成形术（PTCA）。我们成功扩张了23例患者中21例（91%）的35条血管（94%）中的37处病变中的35处（95%）。平均血管狭窄程度从86±22%降至13±19%（p<0.001），并且所有21例血管造影显示成功的患者功能能力均得到改善。9例患者的单支静脉桥血管成功扩张。无一例发生急性心肌梗死或需要急诊手术，但有1例发生了脑栓塞。PTCA是CABS术后复发性心绞痛的有效治疗方法，对许多患者来说比再次手术更可取。
