Interv Akut Kardiol. 2003;2(1):37-39

Intraoperative balloon coronary angioplasty of left main coronary artery ostial stenosis: Long-term favorable outcome

František Holm1, Ivan Vaněk2, Stanislav Šimek4, Karel Goričan3, Vilém Danzig4, Ivo Miler4,2, Michael Aschermann4
1 Kardiologické oddělení, Krajská nemocnice Liberec
2 II. chirurgická klinika kardiovaskulární chirurgie 1. LF UK a VFN, Praha
3 IV. interní klinika VFN a 1. LF UK, Praha
4 II. interní klinika kardiologie a angiologie 1. LF UK a VFN, Praha

In the past, intraoperative balloon coronary angioplasty was considered a useful method, which can improve outcome of coronary artery by-pass grafting. This approach has been abandoned due to technical difficulties. Authors refer a case of 74 years old woman with tight ostial stenosis of the left main coronary artery due to aortic valve replacement with bioprothesis 2 years ago. Her condition was complicated by significant paravalvular leak and left ventrical dysfunction. Intraoperative balloon angioplasty of left main coronary artery was performed following aortic valve replacement with mechanical prothesis. Eight weeks later, coronaroangiography confirmed absence of left main coronary artery stenosis. The patient remained free of chest pain in follow-up of 18 months.

Keywords: left main coronary artery stenosis # intraoperative balloon angioplasty.

Published: December 31, 2003  Show citation

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Holm F, Vaněk I, Šimek S, Goričan K, Danzig V, Miler I, Aschermann M. Intraoperative balloon coronary angioplasty of left main coronary artery ostial stenosis: Long-term favorable outcome. Interv Akut Kardiol. 2003;2(1):37-39.

Intraoperační balonková koronární angioplastika (IOBA) byla považována za přínosnou metodu, která může zlepšit výsledky chirurgické revaskularizace myokardu. Pro řadu technických úskalí je dnes tento postup považován za historický. Autoři referují o případu 74leté nemocné, u které se po dvou letech po aortální náhradě bioprotézou objevila ostiální stenóza kmene levé tepny. Stav byl komplikován významnou aortální regurgitací při paravalvulárním leaku a dysfunkcí levé komory. Vzhledem k vyššímu riziku reoperace byla provedena v mimotělním oběhu po vyjmutí bioprotézy intraoperační balonková angioplastika kmene levé tepny, pod přímou kontrolou zraku bez fluoroskopické kontroly. Poté byla provedena náhrada aortální chlopně mechanickou protézou. Kontrolní koronarografie, provedená po osmi týdnech po operaci, ukázala normální nález na kmeni levé tepny bez známek restenózy. Pacientka během 18měsíčního sledování byla bez bolestí na hrudi.

Intraoperative balloon coronary angioplasty of left main coronary artery ostial stenosis: Long-term favorable outcome. A Case Report

In the past, intraoperative balloon coronary angioplasty was considered a useful method, which can improve outcome of coronary artery by-pass grafting. This approach has been abandoned due to technical difficulties. Authors refer a case of 74 years old woman with tight ostial stenosis of the left main coronary artery due to aortic valve replacement with bioprothesis 2 years ago. Her condition was complicated by significant paravalvular leak and left ventrical dysfunction. Intraoperative balloon angioplasty of left main coronary artery was performed following aortic valve replacement with mechanical prothesis. Eight weeks later, coronaroangiography confirmed absence of left main coronary artery stenosis. The patient remained free of chest pain in follow-up of 18 months.

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