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As technical expertise improves and better devices become available, percutaneous transluminal coronary angioplasty (insertion of a balloon-tipped catheter into the heart to compress blockages against the walls of an artery) can be used in more complicated and dangerous situations. When this procedure is used to dilate the left coronary artery in cases where the right coronary artery is also blocked, there is great risk of producing severe damage to the left ventricle of the heart. In patients with multivessel disease, the effectiveness of percutaneous transluminal coronary angioplasty is unproven. Sixty-one patients were studied who underwent angioplasty of the left coronary artery; these patients also had occlusion of the right coronary artery. Clinical measures showed significant improvement after angioplasty in the patients who did not experience restenosis (recurrence of blockage), but not in the group that did suffer restenosis. In the 34 patients without restenosis, 65 percent had no further symptoms, even though circulation was not completely restored; in addition, myocardial ischemia (reduced blood flow to the heart) occurred less frequently and left ventricular function improved. Transluminal coronary angioplasty cannot be recommended for all patients with multivessel disease. However, these results suggest that prior analysis of the left ventricular angiogram (imaging of the heart) can indicate which patients may benefit from an incomplete revascularization. (Consumer Summary produced by Reliance Medical Information, Inc.)