Coronary transluminal angioplasty: immediate and long-term outcomes. Experience at the Buenos Aires Cardiovascular Institute

pp 137-143

Abstract

Between January 1985 to December 1988, 606 consecutive patients were treated with percutaneous transluminal coronary angioplasty. Unstable angina was present in 79 % of patients. In 80 % of the cases the sintomatology was severe (functional class HI-IV). Primary success of angioplasty was 91 '10 and mortality was 0.8 %. Acute myocardial infarction associated with the procedure was found in 1.7 % of patients. We obtained a 2 years follow up in 97.7 % of patients. In this period, the event free survival was 88.7 %. Twenty six percent of patients had recurrence of typical angina. In 66 % of the reestenosis was found. A close relation between recurrence of simptoms or ischemia and the etiology was recognized as follows: during the first month it was due to incomplete revascularization; between first to thirth month, reestenosis was present in most of the cases; after sixth month reestenosis -was rare, and progression of coronary heart disease was the most frequent finding. Half of the patients with reestenosis returned with angina functional class III-IV, while most of the patients with incomplete revascularization of progression of coronary heart disease had functional class I-II angina (86 % and 75 % respectively). Our results shows that angioplasty is a very good procedure in selectives subsets of patients with high rate of primary success and two year survival, although we should considere the posibility of a new angioplasty in about 20'10 of the cases in the first months of follow up.