Villavicencio R, Córdoba M, Ban Hayashi E, Gaspar J, Gil M, Kuri J, Martínez Ríos M A
Departamento de Hemodinámica del Instituto Nacional de Cardiología Ignacio Chávez, México, D.F.
Arch Inst Cardiol Mex. 1993 Jan-Feb;63(1):41-5.
Coronary angioplasty has shown its efficacy in "high-risk" patients for surgical treatment (severe left ventricular failure, serious pulmonary or systemic disease). We studied a subgroup with multivessel coronary heart disease treated with coronary angioplasty because they were no candidates for surgery due to unsuitable coronary anatomy. Revascularization rate was determined in each patient as revascularization percentage obtained, compared with all the technically suitable lesions for coronary angioplasty. Ten patients (mean age 63 years) were studied, eight of them had unstable angina. Overall, 44 lesions were considered technically suitable for angioplasty and thirty-five could be dilated, technical success rate was 88% (31/35 lesions) and revascularization rate was 71% (31/44 lesions). Primary success rate was achieved in nine patients. Clinical follow-up varied from two to thirteen months (mean 7.8 months); eight patients have remained asymptomatic (class I of NYHA), another patient had stable angina and the other one had sudden death six months after the procedure. In conclusion, we demonstrated a high success rate in a short and long term with coronary angioplasty in a subgroup of patients with multivascular coronary heart disease that had been rejected for surgery due to unsuitable coronary anatomy.
冠状动脉成形术已在手术治疗的“高危”患者（严重左心室衰竭、严重肺部或全身性疾病）中显示出其疗效。我们研究了一组接受冠状动脉成形术治疗的多支血管冠心病患者，因为他们由于冠状动脉解剖结构不合适而不适合进行手术。通过将获得的血运重建百分比与所有适合冠状动脉成形术的技术病变进行比较，确定每位患者的血运重建率。研究了10名患者（平均年龄63岁），其中8名患有不稳定型心绞痛。总体而言，44处病变在技术上适合进行血管成形术，35处可以扩张，技术成功率为88%（31/35处病变），血运重建率为71%（31/44处病变）。9名患者取得了初步成功。临床随访时间从2个月到13个月不等（平均7.8个月）；8名患者无症状（纽约心脏协会I级），另一名患者患有稳定型心绞痛，另一名患者在手术后6个月猝死。总之，我们证明了在因冠状动脉解剖结构不合适而被拒绝手术的多支血管冠心病患者亚组中，冠状动脉成形术在短期和长期都有很高的成功率。
