Outcome of Surgical Angioplasty for Isolated Coronary Ostial Stenosis.
10.4070/kcj.1999.29.1.46
- Author:
Keon Sik MOON
;
Yun Joong KIM
;
Jae Sung KIM
;
Suk Keun HONG
;
Hweung Kon HWANG
- Publication Type:Original Article
- Keywords:
Surgical angioplasty;
Coronary artery disease;
Aortic regurgitation
- MeSH:
Angiography;
Angioplasty*;
Aortic Valve Insufficiency;
Cardiac Output, Low;
Constriction, Pathologic*;
Coronary Angiography;
Coronary Artery Disease;
Echocardiography;
Ergonovine;
Follow-Up Studies;
Humans;
Male;
Pericardium;
Postoperative Complications;
Retrospective Studies;
Spasm
- From:Korean Circulation Journal
1999;29(1):46-54
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: Although surgical angioplasty for isolated coronary ostial stenosis is assumend as an alternative approach to CABG, the clinical features of isolated coronary ostial stenosis, postoperative complications and follow-up angiographic results would have not been well studied. METHODS: We retrospectively studied 24 patients (female : male = 20 : 4, mean age 50.0 +/- 12.3 yr) who underwent surgical angioplasty for isolated coronary ostial stenosis using patch ( 22 fresh autologous pericardium, 2 saphenous vein) during the period of March 1990 through February 1998. Repeat coronary angiography (16 patients) and echocardiography (24 patients) were performed. Aortic regurgitation was evaluated semiquantitatively (Grade I - Grade IV). RESULTS: There were 3 deaths after surgical angioplasty. One death was due to acute coronary dissection perioperatively, the second due to low cardiac output syndrome 2 weeks post-surgery, and the third due to traumatic panperitonitis 10 months post-procedure. Angina recurred in 4 patients and the remaning 18 patients were symptom-free. Repeat angiography (19.3 +/- 20.7 Mo) showed widely patent ostium with excellent run-off except 2 patients (1 distal patch stenosis, 1 ostial restenosis in Takayasu's arteritis). The third symptomatic patient was proven to have coronary spasm by ergonovine test. AR increased in the fourth patient (Grade II -> III) with patent ostium. CONCLUSION: Surgical angioplasty may be feasible and alternative operative method to CABG for isolated coronary ostial stenosis. It should however be noted that postop AR can develop and/or increase. Further investigation is needed to evaluate the clinical significance of the AR.
