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European Heart Journal 1993 14(10):1354-1364;
Copyright © 1993 by the European Society of Cardiology.
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© 1993 The Europen Society of Cardiology

The impact of balloon angioplasty of coronary artery and/or vein bypass graft lesion(s) upon the survival of patients ≥ 5 years after their last bypass surgery

G. DORROS*,{dagger},, S. IYERJ{ddagger}, L. M. MATHIAK* and A. J. ANDERSON§

*The William Dorros-Isadore Feuer Interventional Cardiovascular Disease Foundation, Ltd. Milwaukee, WI, U.S.A.
{dagger}Clinical Professor in Medicine, University of Wisconsin-Madison Madison, WI, U.S.A.
{ddagger}University of Alabama Birmingham, AL
§Biostatistician at Milwaukee Cardiovascular Data Registry Milwaukee, WI, U.S.A.

Received 6 January 1992; revised 30 April 1993; .

Correspondence: Gerald Dorros, MD, FESC, 2901 West Kinnickinnic River Parkway, #LL6, Milwaukee, WI 53215, U.S.A.

Abstract

Data analyses of angioplasty patients, whose operative and angioplasty (PTCA) intervalwas ≥ 5 years, were performed to determine if the site of PTCA (coronary artery (CA) and/or vein bypass graft (VG)) influenced longevity. PTCA was successful in 677/768 lesions (88%) (377/432 CA (87%), and 294/327 VGs (90%)) and resulted in clinical improvement in 280/322 patients (87%). Patients were stratified into those who underwent PTCA of a lesion(s) in a coronary artery only, a vein graft only, or in both a coronary artery and a vein graft. Survival, at 60 months, was adversely affected (P<0.05) for VG (59%) in comparison to CA (86%) or CA $ VG (86%) cohorts, which was reaffirmed by a Cox proportional hazard model.

PTCA was effective in opening lesions in coronary arteries or vein grafts in patients whose last bypass surgery had occurred over 5 years previously; however, PTCA patients who only had a vein graft had a significantly diminished 5-year survival in comparison to the cohorts, who had a coronary artery lesion dilated, with or without an accompanying vein graft PTCA. Therefore, PTCA of isolated vein graft lesions may not be the best long-term therapeutic option for these patients; however, it may best serve patients, acutely and long-term, who have an emenable significant arterial lesion, whether or not an accompanying vein graft lesion is dilated.

Key Words: PTCA in CABG patient • PTCA of old vein grafts


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