During the past several years, there have been dramatic changes in the therapeutic approach to coronary artery disease. Percutaneous transluminal coronary angioplasty (PTCA) and thrombolytic therapy are being increasingly utilized, and the indications for coronary artery bypass grafting are being refined. First used in patients with coronary artery disease (CAD) in 1977, PTCA has gained wide acceptance as an alternative form of myocardial revascularization. Patients with unstable angina, initially considered to be unsuitable candidates for PTCA, have now undergone this procedure, with initial success rates of 93% reported.1 Multivessel PTCA is now being performed with excellent short-term results and acceptable complication rates.
As an extension of PTCA, balloon angioplasty has been successfully used to treat pediatric patients with coarctation of the aorta, pulmonary stenosis, and mitral stenosis. Several centers have used percutaneous balloon valvuloplasty, with promising short-term results, to treat adults with aortic and mitral stenosis.2