The results of primary percutaneous transluminal coronary angioplasty
(PTCA) to treat patients with acute myocardial infarction in a rural h
ospital were reviewed. Thirty-five patients presenting with acute myoc
ardial infarction, including 40% considered high risk, were treated us
ing the strategy of primary angioplasty. Following cardiac catheteriza
tion, two patients were found to have anatomy deemed unsuitable for pr
imary angioplasty and subsequently underwent urgent coronary artery by
pass graft (CABG) surgery. Thirty-three patients underwent primary ang
ioplasty with a procedural success rate of 94%. Procedural success was
defined as reduction of the infarct arteries stenosis to less then 50
% and the establishment of TIMI-III flow. Six percent of these patient
s required urgent CABG surgery because of unsuccessful angioplasty. In
-hospital cardiac mortality was 3%. Six month follow-up was achieved f
or all patients. There were no cardiac deaths following hospital disch
arge. Recurrent ischemia occurred in 17% of the patients. Favorable in
-hospital and late results were achieved. This review indicates that t
he strategy of primary angioplasty to treat myocardial infarction may
be successfully applied in a rural setting.