Intraoperative angioplasty and coronary artery bypass grafting for the treatment of multisegmental coronary artery disease.

Abstract

This report summarizes our experience with intraoperative angioplasty and coronary artery bypass graft surgery for the treatment of multisegmental coronary artery disease. The indication for intraoperative angioplasty was the presence of diffuse, symptomatic, coronary artery disease with at least one coronary artery having two or more areas of narrowing. The balloon catheter was introduced through an arteriotomy and advanced through the point of obstruction. The balloon was then inflated to 6 atmospheres for 15-20 seconds. This procedure was repeated two to three times. The time required for this technique averaged less than 5 minutes. Although there were no documented intraoperative perforations, intimal injuries were observed in two patients at the time of postoperative catheterization. Early and late postoperative angiograms showed that approximately 30% of angioplastied vessels had an improvement in their dilated lesions. Patients with discrete areas of narrowing had greater improvement in luminal diameter than those with diffuse narrowing (49% versus 17%). There was no difference in graft patency or left ventricular wall motion between vessels that did or did not undergo angioplasty.