de la Llata Romero M, Hernández J G, Silva Oropeza E
Hospital de Cardiología Luis Méndez, CMN, IMSS, México, D.F.
Arch Inst Cardiol Mex. 1989 Sep-Oct;59(5):481-6.
Between December, 1985, and May, 1988 we have performed coronary angioplasty of 14 lesions in 12 patients. Before angioplasty 8 patients had a history of unstable angina, and 3 developed angina after streptokinase because of an acute myocardial infarction. We attempted angioplasty of 11 proximal and 3 distal lesions; these included a coronary bypass graft lesion, and 3 lesions in one vessel. We successfully dilated 12 lesions (85%). The coronary stenosis was reduced on average from 84.2 +/- 9 to 17.5 +/- 7 per cent (P less than 0.0001); and the pressure gradient was reduced from 74 +/- 16.25 to 18.3 +/- 9 mmHg (P less than 0.001). Procedure-related complications included: coronary occlusion in 4 patients (28.5%) that were successfully resolved during angioplasty in 3 patients, but one developed myocardial infarction (8.3%); and one urgent surgery and death in a patient with 3 vessel disease. Twelve patients (83%) with no evidence of myocardial ischemia returned to their normal activities. These initial data confirm coronary angioplasty as a safe, efficatious and successful alternative in the management of selected patients with coronary artery disease.
在1985年12月至1988年5月期间,我们对12例患者的14处病变进行了冠状动脉血管成形术。血管成形术前,8例患者有不稳定型心绞痛病史,3例在链激酶治疗后因急性心肌梗死出现心绞痛。我们尝试对11处近端病变和3处远端病变进行血管成形术;其中包括1处冠状动脉搭桥移植病变,以及同一血管内的3处病变。我们成功扩张了12处病变(85%)。冠状动脉狭窄平均从84.2±9%降至17.5±7%(P<0.0001);压力阶差从74±16.25 mmHg降至18.3±9 mmHg(P<0.001)。与手术相关的并发症包括:4例患者(28.5%)发生冠状动脉闭塞,其中3例在血管成形术中成功解决,但1例发生心肌梗死(8.3%);1例三支血管病变患者进行了急诊手术并死亡。12例(83%)无心肌缺血证据的患者恢复了正常活动。这些初步数据证实,冠状动脉血管成形术是治疗部分冠状动脉疾病患者的一种安全、有效且成功的替代方法。