[Direct coronary bypass operation in complicated coronary dissection].

Improvement of interventional techniques, sophisticated patient selection, and individual experience has decreased the probability of emergency operative revascularization of increasing numbers of PTCA cases in recent years. This rate is now between 0.5 to 3%, including highrisk dilatations. Dissection is the most common complication of PTCA, while perforation is rare. Patients with high risk for PTCA-procedures (age, concomittant diseases, female gender) are, in general, risk patients for operative revascularization. The postoperative course of emergency bypass surgery after PTCA-complication (infarction rate, mortality) is dependent on duration and severity of the myocardial ischemia and preoperative circulatory function. Complete revascularization in cases of multi-vessel disease and the use of the internal mammary artery as a graft vessel is being achieved in increasing numbers.