Surgical Management of Prinzmetal's Variant Angina

Clinical data, coronary arteriographic findings and results of surgery are analyzed in six patients with Prinzmetal's variant angina who underwent saphenous vein aorta to coronary bypass. Eighteen additional cases from the literature are also surveyed. Postoperatively, only 38 percent (9 of 24) of the entire surgically treated group were free of pain with no evidence of myocardial infarction. There was lack of symptomatic improvement in 29 percent (7 of 24); 21 percent (5 of 24) had symptomatic improvement but myocardial infarction or graft occlusion or both had been documented. Early mortality was 12 percent (3 of 24). In patients with variant angina, surgical results are inferior to those generally obtained in patients with classic angina. In patients with demonstrable coronary artery spasm, bypass surgery has been uniformly unsuccessful.