Emergency coronary artery bypass grafting for failed percutaneous transluminal coronary angioplasty]

There were 1151 patients who underwent PTCA at our facilities from August 1984 to December 1990. The records of 298 patients were reviewed from August 1984 to June 1988 (former period), and were compared with records of 853 patients undergoing treatment after June 1988 (latter period). Of 852 elective PTCA procedures, complete occlusion of the lesion increased from 2.3% in the former period to 17.5% in the latter period, while for partial occlusion there were 60.4% in the former and 60.5% in the latter. Emergency PTCA for acute myocardial infarction decreased from 37.2% in the former to 22% in the latter. The number of patients with multivessel disease increased slightly from 43.6% in the former to 46.8% in the latter. The success rate for patients who underwent elective PTCA for complete occlusion was 42.8% in the former and 49.6% in the latter, while for partial occlusion it was 87.2% in the former and 91.8% in the latter. The success rate for patients requiring emergency PTCA was 73.8% in the former and 90.4% in the latter. Of the patients undergoing elective PTCA, acute coronary closure occurred in 3% of the former and in 1% of the latter, while for patients requiring emergency PTCA, there were 4.4% in the former and 2.7% in the latter. Of the 8 patients who required emergency CABG, elective PTCA was unsuccessful in 4 cases and emergency PTCA was also unsuccessful in the other 4; in other words, 4 of a total 852 elective PTCAs (0.47%) and 4 of 299 emergency PTCAs (1.3%) for an overall figure of 8/1151 (0.7%).(ABSTRACT TRUNCATED AT 250 WORDS)