Short-term outcome and long-term follow-up following coronary angioplasty in the young patient: An 8-year experience

Abstract

From 8000 consecutive percutaneous transluminal coronary angioplasty (PTCA) procedures performed between 1980 and 1988, 89 separate PTCA procedures (1.1%) were performed in 71 patients ≤35 years of age. Multivessel disease was present in 41 patients (58%). Eleven procedures (12.4%) were done for acute myocardial infarction. Of 253 lesions attempted, 242 (95.6%) were successfully dilated. Complications consisted of just a single urgent bypass operation (1.1%). At mean follow-up of 32 months, 50 patients (72.5%) were asymptomatic. Late events consisted of one death (1.4%), four nonfatal infarctions (5.8%), and seven bypass surgeries (10.1%). Seventeen patients (24.6%) required 25 repeat PTCAs; restenosis was present in 12 of these patients while progression of native disease was noted in nine patients. In the young patient with coronary artery disease, PTCA can be performed safely, with a high success rate and few complications. Though the 3-year survival is excellent, a significant proportion of these patients develop nonfatal infarction or require repeat PTCA or bypass surgery, often for progression of native disease in addition to restenosis.