Summary
Percutaneous transluminal dilatation (PTD) of coronary stenosis is performed by means
of a balloon-tipped catheter introduced from a peripheral artery. PTD was attempted
in 56 patients; stenosis was successfully dilated in 38 patients (68 %). The method
failed in 18 patients: in 6 (11 %) of them an abrupt closure of the stenosed artery
or a beginning infarction necessitated an emergency revascularization. There were
no serious complications or deaths; one patient developed a transmural infarction
in spite of the immediate bypass grafting. PTD was also successful in 6 out of 9 patients
with recurrent angina following previous coronary bypass grafting. Intraoperative
dilatation by coronary arteriotomy was attempted in 6 patients, but the results were
in-conclusive.
PTD is a new method of treatment of coronary artery disease; it represents an addition
rather than an alternative to coronary bypass grafting. The decision for PTD should
be made jointly by cardiologist and surgeon; the ideal patient has a short history
of angina with narrow, proximal stenosis without any calcifications. Cardiosurgical
standby is mandatory during PTD; the results are best and the risk lowest in patients
with single vessel disease.
Key-Words:
Coronary artery stenosis - Transluminal coronary dilatation - Aorto-coronary bypass
