Nonsurgical myocardial revascularization: initial experience with percutaneous transluminal coronary angioplasty.

Coronary artery atheromata obstruct coronary blood flow and produce myocardial ischemia. Percutaneous transluminal coronary angioplasty (PTCA) was performed to dilate narrowed coronary arteries on 16 occasions in 15 patients with severe proximal coronary artery narrowings and significant clinical angina pectoris. The lesions involved the left-anterior descending (LAD) coronary artery in nine patients (10 dilatation procedures), the right coronary artery (RCA) in five, and the circumflex coronary artery in one. Successful dilatation was achieved on nine occasions (56%): in 7 of the 10 LAD lesions (70%), in 2 of the 5 RCA lesions (40%), but not in the patient with circumflex disease. Successful dilatation was accompanied by a significant improvement in symptoms and in myocardial performance, as judged by atrial pacing MUGA (multigated) ventriculography. The ischemic response of the ventricle to stress the significantly reduced or abolished. PTCA is a useful, nonoperative method for dilating obstructed coronary arteries and for improving myocardial blood flow.