Hofmann R, Kerschner K, Felbermayr M, Leisch F
I. Medizinische Abteilung, Allgemeines Krankenhaus, Linz.
Wien Klin Wochenschr. 1993;105(1):17-20.
342 consecutive patients with recurrent angina pectoris were investigated 4.9 +/- 2.9 years after bypass surgery. According to the respective coronary morphology, angioplasty (PTCA) was performed in 110 patients (32%), repeat surgery in 32 (9%) and 200 patients (58%) were treated medically. Angioplasty was undertaken in 113 native coronary arteries (18 via a patent venous graft) and 29 bypass grafts. One vessel was dilated in 84 patients (76%) and more than one vessel in 26 patients (24%), giving an average of 1.3 vessels per patient. The initial success rate was 84% (120 of 142 vessels). The success rate varied from 60% in the midportion of venous grafts to 100% in the bypass protected left main stem. One patient died from complications (0.9%) and 5 patients (4.5%) suffered a myocardial infarction. Revascularisation was complete in 64 patients (58%) and remained incomplete in 40 patients. Clinical state improved in all but 7 patients and 70 patients (64%) became symptom-free. After 6 months 88 patients were clinically reevaluated. 52 patients (59%) still showed improvement in anginal status or remained symptom-free. Due to recurrent symptoms a re-angioplasty was performed on 21 patients and 6 patients had to be reoperated. In conclusion, coronary angioplasty is frequently a feasible alternative to reoperation with calculable risks in patients with recurrence of symptoms after prior bypass surgery.
