J.Jpn. Surg. Soc.
ISSN 1880-1129

[Abstract] [Full Text PDF] （in Japanese / 2194KB） [Members Only And Two Factor Auth.]

J.Jpn. Surg. Soc.. 93(9): 1006-1009, 1992

Report on the annual meeting

COMPARATIVE STUDY OF CABG FOLLOWING PTCA AND PTCA FOLLOWING CABG

1) Department of Thoracic Surgery, Nagoya University School of Medicine, Nagoya, Japan
2) Department of Cardiology, Kasugai City Hospital, Kasugai, Japan
3) Department of Internal Medicine, Handa Hospital, Handa, Japan

Yuichi Hirate1), Toshio Abe1), Kenzo Yasuura1), Minoru Tanaka1), Tadayuki Kato2), Kunihiko Iida2), Seiya Tsuchiya3)

Forty-five cases of PTCA with prior CABG and 14 cases of CABG with prior PTCA were studied on their pathogenesis and results. Ninety-four PTCA procedures were performed electively after CABG on 45 patients and 145 lesions. Lesion success rates were 95.8% in stenosis and 55.6% in occluded vessel. The mortality was none and no emergent surgery was needed. Causes of PTCA following CABG included the progression of coronary artery disease (13.1%), graft stenosis (15.0%), graft occlusion (31.0%), incomplete revascularization (13.8%), restenosis after the initial procedure (26.2%). Especially percentage of the progression of coronary artery disease was increased with a lapse of time, and it was 31.7% in PTCA group over 3 years after CABG. Fourteen patients with prior PTCA were received CABG because of unsuccessful PTCA (50.0%), progression to LMCD (21.4%), restenosis (21.4%), and PTCA complication (7.1%). Both interventions were appropriate and useful to reduce the recurrent ischemia and cardiac events with each other. Myocardial revascularization should not be considered either PTCA or CABG, but PTCA and CABG. In conclusion the strategy that much more benefits can be obtained from supplementary use of PTCA and CABG makes it possible to reduce the mortality and morbidity associated with intervention.

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