RESUMO
A white male patient, 59 years old, with two prior surgical myocardial revascularization and unstable angina, was submitted to coronary arteriography that showed: all the saphenous vein grafts patent and obstruction of 75% in the saphenous vein graft to the second marginal branch of left circumflex artery. Left internal mammary artery (LIMA) was angiographically normal and 80% stenosis was detected in the distal segment of the left anterior descending coronary artery (LAD). The patient was submitted to directional coronary atherectomy for saphenous vein graft and coronary angioplasty for distal-LAD. Both procedures were successfully performed.
Assuntos
Angioplastia Coronária com Balão , Aterectomia Coronária/métodos , Doença das Coronárias/terapia , Revascularização Miocárdica , Ponte de Artéria Coronária , Doença das Coronárias/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , ReoperaçãoRESUMO
Four male patients, 38 to 59 years old (mean 49 +/- 2.5), with angina and the angiographic features has been the classical indications for the method, underwent directional coronary atherectomy. Vessels treated were, respectively, left anterior descending artery (LAD), right coronary artery (RCA), saphenous vein graft (SVG) to LAD and SVG to left marginal branch. Reductions to 50% or less of the internal diameter was considered a satisfactory result. Early success was obtained in all four patients. Obstructions of 75 to 95% (mean of 83 +/- 7.5%) were reduced to 0-25% (mean 12 +/- 5%) after atherectomy. Only one patient died suddenly five days after de procedure. So, directional coronary atherectomy may represent a reliable and safe method for special situations.