Coronary Circulation in Patients with Previous Angioplasty

pp 661-670

Abstract

Introduction

The annual increase in the number of angioplasties performed challenges us, more frequently with patients requiring coronary surgery, already submitted to an angioplasty in the past. The weight of this background on their future evolution is un-known at present.

Objectives

1) To establish the percentage of patients requir-ing surgery with a background of previous success-ful angioplasty (remote). 2) To perform a carefulanalysis of their prognosis.

Material and methods

The total coronary surgeries were considered in four centers between 1-1-1997 and 1-10-1999. Valvular or combined surgeries, primary or rescue angioplasties were excluded. Perioperative morbility and mortality were considered. A p valueless to 0.05 was considered statistically significant.

Results

Four hundred and fifty-nine patients were included: 47 or them (10.2%) with a previous successful angioplasty. The general characteristics of the population, number of grafts and endarterectomies performed, and also the surgical time were similar in both groups (angioplasty and control group). Overall mortality was 33 patients: eight of them hada previous angioplasty (17%) compared to 25 (6%)deaths in the control group (6%) (p=0.05). The presence of post-operative complications such as perioperative- infarction (17% -8/47- vs. 5.3%-22/412-), use of intra-aortic balloon pumping (34%-16/47- against 11.8% -48/412-), the presence of arrhythmias (29.7% -14/47- vs. 13.1% -54/412-), and renal failure (17% -8/47- vs. 5.1%-21/412-) were higher in those patients submitted to a previous angioplasty.

Conclusions

1) Ten percent of the patients were submitted to a previous remote successful angioplasty. 2) The presence of such a background was associated with a higher rate of perioperative morbility and mortality.