Percutaneous transluminal coronary angioplasty is an accepted treatment for selected patients with ischemic heart disease. This study reports on the primary angiographic success, complications and clinical improvement in our first 22 patients in this institution. Between October 1985 and July 1986 a total of 22 patients, including 15 patients with unstable angina, underwent coronary angioplasty with a total of 37 stenosis greater than or equal to 60%. The number of stenosis per patient varied from one to four. Mean stenosis diameter decreased from 87 +/- 12% to 12 +/- 9% (p less than .00001). Primary success was obtained in 21 patients (95.4%) and in 35 segments (94.5%). In two patients with unstable angina totally occluded vessel was dilated without residual stenosis. One patient in the early stage of a myocardial infarction underwent angioplasty, with 20% residual stenosis and no evidence of necrosis. The only complication related to the procedure was an inferior myocardial infarction in a patient with subtotal obstruction in the distal circumflex. There were no deaths and none of the patients required emergency bypass surgery. Among the 21 patients with successful dilatation, 19 have remained asymptomatic with a mean follow-up of 4.9 +/- 2.5 months. This report shows a high primary success rate and few complications in the first coronary angioplasty procedures performed at our institution. This results need to be confirmed with a greater number of patients and an adequate clinical and angiographic follow-up.