[Surgical plasty of the coronary trunks: an alternative to bypass techniques]

Between January 1991 and December 1993, surgical coronary angioplasty was performed in 12 patients with an average age of 59 years: right coronary artery (17), left main coronary artery (3) and bilateral angioplasty (2). Internal mammary or gastroepiploic artery bypass grafts were associated on another vessel in 5 patients and 1 patient also underwent aortic valve replacement. There was no early mortality (1 month), or perioperative myocardial infarction. At the 15th postoperative day, the angiographic result was satisfactory in all patients. At 6 months, exercise testing was negative in all cases (maximum load 140 +/- 20 watts). Reoperation for bypass surgery was necessary in 1 patient because of symptomatic occlusion of the left anterior descending left anterior descending artery, one year after angioplasty of the left main coronary extending to the proximal left anterior descending. With a mean postoperative follow-up of 19 +/- 7 months (6 to 31 months), all patients are asymptomatic: 5 of the 6 angioplasties controlled angiographically at 1 year were patent without any signs of progression (1 occlusion/reoperation). Surgical angioplasty of the main coronary vessels is a sure and reliable procedure: it restores physiological coronary perfusion, economises venous and arterial vessels and is no obstacle to percutaneous transluminal coronary angioplasty.