Related Experiment Videos
[Surgical plasty of the coronary trunks: an alternative to bypass techniques]
O Jegaden1, A Eker, G Durand de Gevigney
1Service de chirurgie cardiovasculaire, hôpital cardiologique Louis-Pradel, Lyon.
Insights
Surgical coronary angioplasty in main coronary vessels is a safe and effective procedure. It restores blood flow, preserves other vessels, and does not impede future percutaneous interventions.
Area of Science:
- Cardiovascular Surgery
- Interventional Cardiology
Context:
- Surgical coronary angioplasty was performed in 12 patients between 1991 and 1993.
- Procedures involved the right coronary artery, left main coronary artery, and bilateral angioplasty.
- Some patients also received bypass grafts or aortic valve replacement.
Purpose:
- To evaluate the safety and efficacy of surgical angioplasty for main coronary vessels.
Summary:
- No early mortality or perioperative myocardial infarction was observed.
- All patients showed satisfactory angiographic results at 15 days and negative exercise tests at 6 months.
- One patient required reoperation for bypass surgery due to graft occlusion one year post-procedure.
- Mean follow-up was 19 months, with all patients remaining asymptomatic.
- Angiographic follow-up at 1 year showed patent grafts in 5 out of 6 cases.
Impact:
- Surgical angioplasty is a reliable procedure for main coronary vessels.
- It effectively restores coronary perfusion and conserves other available vessels.
- This approach does not preclude future percutaneous transluminal coronary angioplasty.
Abstract:
Between January 1991 and December 1993, surgical coronary angioplasty was performed in 12 patients with an average age of 59 years: right coronary artery (17), left main coronary artery (3) and bilateral angioplasty (2). Internal mammary or gastroepiploic artery bypass grafts were associated on another vessel in 5 patients and 1 patient also underwent aortic valve replacement. There was no early mortality (1 month), or perioperative myocardial infarction. At the 15th postoperative day, the angiographic result was satisfactory in all patients. At 6 months, exercise testing was negative in all cases (maximum load 140 +/- 20 watts). Reoperation for bypass surgery was necessary in 1 patient because of symptomatic occlusion of the left anterior descending left anterior descending artery, one year after angioplasty of the left main coronary extending to the proximal left anterior descending. With a mean postoperative follow-up of 19 +/- 7 months (6 to 31 months), all patients are asymptomatic: 5 of the 6 angioplasties controlled angiographically at 1 year were patent without any signs of progression (1 occlusion/reoperation). Surgical angioplasty of the main coronary vessels is a sure and reliable procedure: it restores physiological coronary perfusion, economises venous and arterial vessels and is no obstacle to percutaneous transluminal coronary angioplasty.