Clinical profile of post coronary artery bypass graft patients undergoing percutaneous coronary intervention in native or graft vessels
DOI:
https://doi.org/10.18203/2349-3933.ijam20201613Keywords:
Acute coronary syndrome, Coronary artery bypass graft, Percutaneous Coronary Intervention, ST-segment elevation myocardial infarctionAbstract
Background: The PCI target vessel and corresponding outcomes in prior CABG patients are poorly studied. The study aims to determine the predictors and outcomes of native coronary artery and bypass graft percutaneous coronary intervention (PCI) in patients with prior coronary artery bypass graft surgery (CABG).
Methods: The factors associated with native and bypass graft PCI were analyzed in prior CABG patients undergoing PCI between July 2011 and December 2013, at Sri Jayadeva Institute Of Cardiovascular Sciences and Research, Bengaluru. Clinical/procedural characteristics and immediate procedural outcomes were recorded and analyzed.
Results: During the study period, 76 patients underwent PCI who were before CABG patients. The PCI target was a native coronary artery in 73.6% and a bypass graft in 28.9%. The majority of patients presented more than five years after the CABG (64.4%). Post PCI angina was seen in 7(9.2%), and in 6(7.8%) patients, procedural complications seen. It was found that most PCI was done in patients who presented more than five years after CABG.
Conclusions: Most PCIs performed in prior CABG patients are done in native coronary artery lesions.
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References
Goldman S, Zadina K, Moritz T, Ovitt T, Sethi G, Copeland JG, et al. Long-term patency of saphenous vein and left internal mammary artery grafts after coronary artery bypass surgery: results from a Department of Veterans Affairs Cooperative Study. J Am Coll Cardiol. 2004 Dec 7;44(11):2149-56.
Morrison DA, Sethi G, Sacks J, Henderson WG, Grover F, Sedlis S, et al. Percutaneous coronary intervention versus repeat bypass surgery for patients with medically refractory myocardial ischemia: AWESOME randomized trial and registry experience with post-CABG patients. J Am Coll Cardiol. 2002 Dec 4;40(11):1951-4.
Boatman DM, Saeed B, Varghese I, Peters CT, Daye J, Haider A, et al. Prior coronary artery bypass graft surgery patients undergoing diagnostic coronary angiography have multiple uncontrolled coronary artery disease risk factors and high risk for cardiovascular events. Heart Vessels. 2009 Jul 1;24(4):241-6.
Brilakis ES, de Lemos JA, Cannon CP, Wiviott SD, Murphy SA, Morrow DA, et al. Outcomes of patients with acute coronary syndrome and previous coronary artery bypass grafting (from the Pravastatin or Atorvastatin Evaluation and Infection Therapy [PROVE IT-TIMI 22] and the Aggrastat to Zocor [A to Z] trials). Ame J Cardiol. 2008 Sep 1;102(5):552-8..
Cameron A, Kemp HG, Green GE. Reoperation for Coronary Artery Disease: 10 Years of Clinical Follow-up. Circulation. 1988;78:I158-62
Weintraub WS, Jones EL, Morris DC, King III SB, Guyton RA, Craver JM. Outcome of reoperative coronary bypass surgery versus coronary angioplasty after previous bypass surgery. Circulation. 1997 Feb 18;95(4):868-77.
Voutilainen S, Verkkala K, Jarvinen A, Keto P. Angiographic 5-Year Follow-up Study of Right Gastroepiploic Artery Grafts. Ann Thorac Surg. 1996;62(2):501-5.
White CW. Benefit of Aggresive Lipid-Lowering Therapy: Insights from the Post Coronary Artery Bypass Graft Study and Other Trials. Am J Med. 1998;105(1A):63S-8S.
Daida H, Yokoi H, Miyano H, Mokuno H, Satoh H, Kottke TE, et al. Relation of saphenous vein graft obstruction to serum cholesterol levels. J Am Coll Cardiol. 1995 Jan 1;25(1):193-7.
Okada H, Tsurumi Y, Kasanuki H, Nishida H, Endo M. Initial Results and Long-Term Outcome of Percutaneous Coronary Intervention in Patients with Previous Coronary Artery Bypass Grafting. J Cardiol. 2001;38(3):111-21.
Varghese I, Samuel J, Banerjee S, Brilakis ES. Comparison of percutaneous coronary intervention in native coronary arteries vs. bypass grafts in patients with prior coronary artery bypass graft surgery. Cardiovasc Revasc Med 2009;10:103-9.
Chen L, Théroux P, Lespérance J, Shabani F, Thibault B, De Guise P. Angiographic features of vein grafts versus ungrafted coronary arteries in patients with unstable angina and previous bypass surgery. J Am Coll Cardiol. 1996;28:1493-9.
Varghese I, Boatman DM, Peters CT, Daye J, Haider A, Roesle M, et al. Impact on contrast, fluoroscopy, and catheter utilization from knowing the coronary artery bypass graft anatomy before diagnostic coronary angiography. Am J Cardiol. 2008 Jun 15;101(12):1729-32.
Garcia-Tejada J, Velazquez M, Hernandez F, Albarran A, Rodriguez S, Gomez I, et al. Percutaneous revascularization of grafts versus native coronary arteries in postcoronary artery bypass graft patients. Angiol. 2009;60:60-6.
Hong MK, Mehran R, Dangas G, Mintz GS, Lansky AJ, Pichard AD, et al. Creatine kinase-MB enzyme elevation following successful saphenous vein graft intervention is associated with late mortality. Circulation. 1999 Dec 14;100(24):2400-5.
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