A CASE OPERATED FOR A THORATIC ESOPHAGEAL CANCER FOLLOWING SUCCESSFUL PERCUTANEOUS TRANSLUMINAL ANGIOPLASTY (PTCA)

Postoperativemyocardial infarction frequently occurs in the patients with angina pectoris or with history of myocardial infarction. Therefore, surgical operation for some disease with a coronary heart disease is controversial.A case of thoratic esophageal cancer recieving radical esophagectomy following successful percutaneous transluminal angioplasty (PTCA) is reported. A 64-year-old male was admitted to the hospital because of upper abdominal pain. There was a history of an attack of a myocardial infarction of the inferior wall when he was 53 years old. He had been suffering from angina pectoris for these 2 months before admission. Esophagography, endoscopy, and endoscopic ultrasonography indicated an early esophageal cancer. Coronary arteriography revealed 90% stenosis on the segment 2 of the right coronary artery. PTCA was performed and the stenosis was improved from 90% to less than 10%. One week later, total tharatic esophagectomy followed by a posterior mediastinal reconstruction using a gastric tube was carried out. Postoperative course was satsifactory. The patient is doing well now with niether evidence of recurrence of cancer not the attack of angina pectoris at the 24th month following the operation.Radical operation is encouraged to perform for the esophageal cancer with coronary heart disease, provided that preoperative PTCA is successfully carried out.