Preliminary Experience with Intraoperative Transluminal Balloon-Catheter Dilation and Coronary Arte of Symptomatic D 2i.U se Coronary Artery Disease Bypass Grafting for the Treatment

Transluminal balloon-catheter dila- tion of coronary artery lesions has become increas- ingly common in the cardiac catheterization labora- tory. We describe a method of intraoperative dilation that may improve surgical results when used in combination with coronary artery bypass graft (CABG) operations in patients with diffusely dis- eased coronary arteries. In 16 patients, long-segment intraoperative dilations were performed to enlarge luminal narrowings in 21 different regions. All of these patients had postoperative coronary angiog- raphy and left ventriculography so that we could objectively evaluate the coronary dilatations. There were no operative deaths or perioperative myo- cardial infarctions, and angina was relieved in all patients. Of the 21 dilated segments, 12 (57%) were unchanged, 2 (10%) became worse, and 7 (33%) were improved postoperatively. In addition, two new areas of intimal damage were detected in patients with unchanged postoperative luminal diameters. We conclude that further experience and longer follow-up are necessary before the efficacy of intra- operative coronary artery balloon-catheter dilation can be accurately determined. The recent development of a catheter technique for dilating stenosed coronary arteries has gen- erated considerable interest (l-31. This new technique, termed percutaneous transluminal coronary angioplasty (PTCA), involves the in-