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Ann Thorac Surg 1979;28:103-112
© 1979 The Society of Thoracic Surgeons

Articles

The Role of the Surgeon in Percutaneous Transluminal Dilation of Coronary Stenosis

Marko Turina, M.D.*, Andreas Grüntzig, M.D., Christoph Krayenbühl, M.D., Åke Senning, M.D.

From the Surgical Clinic A and Department of Internal Medicine, University Hospital, Zurich, Switzerland

* Address reprint requests to Dr. Turina, Professor of Surgery, University Hospital, 8091 Zurich, Switzerland

Percutaneous transluminal dilation (PTD) of coronary artery stenosis is performed by means of a balloon-tipped catheter introduced from a peripheral artery. It was attempted in 45 patients; stenosis was passed in 33 and was successfully dilated in 28 patients (62%). The method failed in 17 patients: in 6 of them an abrupt closure of a stenosed artery or a beginning infarction necessitated an emergency revascularization. There were no deaths or serious complications, but an infarction developed in 1 patient despite immediate bypass grafting. PTD was successful in 5 out of 7 patients who had recurrent angina after previous coronary bypass grafting: in 2 of them stenosis of a distal coronary artery and in 3 a stenosed bypass graft were dilated. PTD is a new method of treatment of coronary artery disease and is an addition rather than an alternative to coronary bypass grafting. The best results can be expected in patients with single-vessel disease, with a short history of angina (less than 1 year), and with narrow, noncalcified proximal stenosis. Some late complications of bypass grafting are also amenable to this method of treatment.




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