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[冠状动脉血管成形术:墨西哥城西班牙医院的经验]

[Coronary angioplasty: experience at the Hospital Español of Mexico City].

作者信息

Mata L A, Frade J, Paras Chavero E

出版信息

Arch Inst Cardiol Mex. 1986 Nov-Dec;56(6):491-7.

PMID:2952076
Abstract

Percutaneous transluminal coronary angioplasty is an accepted treatment for selected patients with ischemic heart disease. This study reports on the primary angiographic success, complications and clinical improvement in our first 22 patients in this institution. Between October 1985 and July 1986 a total of 22 patients, including 15 patients with unstable angina, underwent coronary angioplasty with a total of 37 stenosis greater than or equal to 60%. The number of stenosis per patient varied from one to four. Mean stenosis diameter decreased from 87 +/- 12% to 12 +/- 9% (p less than .00001). Primary success was obtained in 21 patients (95.4%) and in 35 segments (94.5%). In two patients with unstable angina totally occluded vessel was dilated without residual stenosis. One patient in the early stage of a myocardial infarction underwent angioplasty, with 20% residual stenosis and no evidence of necrosis. The only complication related to the procedure was an inferior myocardial infarction in a patient with subtotal obstruction in the distal circumflex. There were no deaths and none of the patients required emergency bypass surgery. Among the 21 patients with successful dilatation, 19 have remained asymptomatic with a mean follow-up of 4.9 +/- 2.5 months. This report shows a high primary success rate and few complications in the first coronary angioplasty procedures performed at our institution. This results need to be confirmed with a greater number of patients and an adequate clinical and angiographic follow-up.

摘要

经皮腔内冠状动脉成形术是治疗某些缺血性心脏病患者的一种公认的治疗方法。本研究报告了本机构首批22例患者的首次血管造影成功情况、并发症及临床改善情况。1985年10月至1986年7月,共有22例患者接受了冠状动脉成形术,其中包括15例不稳定型心绞痛患者,共37处狭窄大于或等于60%。每位患者的狭窄数量从1处到4处不等。平均狭窄直径从87±12%降至12±9%(p<0.00001)。21例患者(95.4%)和35处节段(94.5%)获得了初步成功。2例不稳定型心绞痛患者的完全闭塞血管被扩张,无残余狭窄。1例处于心肌梗死早期的患者接受了血管成形术,残余狭窄20%,无坏死迹象。与该手术相关的唯一并发症是1例患者在左旋支远端次全梗阻时发生下壁心肌梗死。无死亡病例,也无患者需要急诊搭桥手术。在21例扩张成功的患者中,19例在平均4.9±2.5个月的随访期内仍无症状。本报告显示,在本机构进行的首批冠状动脉成形术手术中,初步成功率高,并发症少。这一结果需要通过更多患者以及充分的临床和血管造影随访来证实。

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