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Ann Thorac Surg 1982;33:359-364
© 1982 The Society of Thoracic Surgeons

Articles

Surgical Therapy for Prinzmetal's Variant Angina

Edgar C. Schick, Jr., M.D.*, Zev Davis, M.D., Robert M. Lavery, M.D., John R. McCormick, M.D., Martha Fay, M.A., Robert L. Berger, M.D.

From the Department of Cardiothoracic Surgery and the Section of Cardiology, Evans Memorial Department of Clinical Research and Department of Medicine, University Hospital, Boston University Medical Center, Boston, MA.

Accepted for publication June 26, 1981.

* Address reprint requests to Dr. Schick, Department of Cardiology, University Hospital, 75 E Newton St, Boston, MA 02118.

Fifty-two patients underwent coronary artery bypass grafting between 1973 and 1979 for variant angina, defined as pain, usually at rest, associated with S-T segment elevation. Only patients with fixed occlusive coronary artery disease, defined as greater than 70% narrowing in diameter, were included. When fixed coronary artery stenosis is present, variant angina—whether presenting as stable, unstable, or postinfarction angina, and regardless of the number of vessels diseased—is effectively treated by myocardial revascularization. Preoperative intraaortic balloon pumping is a useful therapeutic adjunct in the unstable subset refractory to medical therapy. The results of revascularization in patients with Prinzmetal's variant angina and fixed coronary disease were no different from those in patients with classic angina pectoris of comparable clinical categories.




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