作者观察了4例冠状动脉左前降支经皮冠状动脉腔内血管成形术(PTCA)后死亡患者的冠状动脉形态学改变。4例术前均有1～2个月劳力性心绞痛。1例PTCA 后4小时死于旁路手术,1例术后80天死于车祸,另2例分别于术后90和150天突然死于家中或工作中。上述第1例于死亡前4小时行冠状动脉造影及 PTCA,发现左前降支管径狭窄80%,经PTCA 后狭窄段被扩张,跨狭窄段冠状动脉平均压力阶差下降了20毫米汞柱。3例 PTCA 后远期死亡者术前左前降支管径狭窄均为76～95%,术中分别扩张到55%、60%和65%,冠状动脉平均压力阶差分别下降了17、38和43毫米汞柱。此3例在术后症状均有改善,仅1例于最后45天出现3次轻微的劳力性心绞痛。 We examined the morphologic changes of coronary arteries in 4 patients who died of coronary artery left anterior descending coronary artery after percutaneous transluminal coronary angioplasty (PTCA). 4 cases of preoperative 1 to 2 months of exertional angina. One patient died of bypass operation 4 hours after PTCA, one died of a car accident 80 days after operation, and the other 2 died of sudden death at home or at work 90 and 150 days after operation. In the first case, coronary angiography and PTCA were performed 4 hours prior to death and found that the diameter of the left anterior descending branch was narrowed by 80%. After the PTCA, the stenosis was expanded and the average pressure gradient across the narrowing coronary artery decreased by 20 mmHg. Preoperative left anterior descending branch diameter stenosis was 76-95% in 3 cases of long-term death after PTCA, which were respectively expanded to 55%, 60% and 65% during surgery, and the mean pressure gradient of coronary arteries decreased by 17,38 and 43 mm Hg. The 3 patients had an improvement in their postoperative symptoms, with only 1 patient having 3 mild labor-induced angina on the last 45 days.