Long-term follow-up of PTCA of the right coronary artery with shepherd’s crook morphology
E. Murat Tuzcu, MD
Conrad Simpfendorfer, MDAddress reprint requests to C.S., Department of Cardiology, The Cleveland Clinic Foundation, One Clinic Center, 9500 Euclid Avenue, Cleveland, Ohio 44195.
David Gossman, MD
Kavita Badwhar, MA
The authors evaluated the long-term outcome of percutaneous transluminal coronary angioplasty (PTCA) of the right coronary artery in patients with shepherd’s crook morphology (51 patients) compared to a control group (53 patients) matched for lesion location, date of procedure, age, and gender. The primary success rate was lower (86% v 98%; P=.03) in the shepherd’s crook group than in the control group. At a mean follow-up of 29 months, there was one death in each group. The restenosis rate was 18% in the shepherd’s crook group and 21 % in the control group; repeat PTCA (14% v 15%) and bypass surgery (2% v 6%) rates were also similar in both groups. The data suggest that PTCA of right coronary arteries with shepherd’s crook morphology has a significantly lower primary success rate but similar long-term outcome when compared to PTCA of right coronary arteries without this anatomic variation.