[Acute aortocoronary bypass in the complications following catheter dilatation of the coronary arteries].

Among 762 patients who had transluminal coronary angioplasty (TCA) 39 developed clinical and ECG signs of intermittent or persistent ischaemia for which immediate surgical revascularisation was performed in the hope of preventing infarction. Of the 39 patients 31 had permanent and 8 intermittent ischaemia. Two of the 31 died, of the remaining 29 with permanent ischaemia 27 still had signs of infarction in the ECG on follow-up, despite successful revascularisation; 24 of them were free of symptoms. In two patients with permanent signs of ischaemia and in eight with intermittent ischaemia the ECG was the same before and after revascularisation. If after TCA there is vascular occlusion with permanent transmural ischaemia, it is usually not possible, even under optimal conditions, to prevent infarction because the ischaemia tolerance of the human myocardium at normothermia will have been exceeded.