Surgical intervention following failed percutaneous coronary angioplasty.

Percutaneous transluminal coronary angioplasty (PTCA) was performed on 725 occasions at the National Hospital of Norway in 1981-1990. Acute surgical intervention was necessary within 24 hours after PTCA in 15 cases, on indications that included coronary artery dissection (8 cases) and acute thrombotic occlusion (5). Electrocardiographic signs of ischemia were present in 11 patients with anginal pain, while two had severe angina but normal electrocardiogram. Two patients had a non-ischemic indication for surgery. Despite surgery, ten of the 15 patients had acute myocardial infarction. One of the ten died. At follow-up nine of 12 patients were free from angina and three had recurrent symptoms.