The present study is a retrospective analysis of 15 percutaneous angioplasty procedures of the left main coronary artery performed in 12 patients (8 males (66%) with a mean age of 64 +/- 12 (range 45-79) years. Twelve dilatations were elective: 8 for unstable angina, 3 for stable angina, and 1 after a recent myocardial infarction. All elective patients were protected with at least 1 patent graft to the distal left coronary artery. Emergency dilatation for evolving myocardial infarction with cardiogenic shock was done in 3 patients. The right coronary artery was dominant in 11 cases. The mean ejection fraction was 49 +/- 18% (range 21-7%). All dilatations were done through the femoral approach. Two dilatations were performed with the "kissing balloon" technique and 2 with the "kissing wire" technique. An intra-aortic balloon counterpulsation was used in 3 cases (21%). In 8 cases (53%), 1 additional coronary artery was dilated in the same session. The technical success rate was 100% and the clinical success rate 73%. For the elective dilatations, the technical success rate was 100% and the clinical success rate 92% (11/12). Four patients died during hospitalisation (27%). The mortality rate was 100% (3/3) for emergency dilatations and 8% (1/12) for elective dilatations (patient with dilatation of 3 vessels and 1 graft in the same session). After a mean follow-up of 25 +/- 28 (rang 1-88) months, the 8 patients discharged from hospital were alive.(ABSTRACT TRUNCATED AT 250 WORDS)