Myocardial Ischemia in Patients with Previous Coronary Artery Bypass Surgery. Angiographic Findings and Therapeutics Options

pp 597-604

Abstract

In the last thirty years coronary artery bypass surgery has become one of the most important tools in the treatment of an increasing number of patients with coronary heart disease. Nevertheless, this procedure is just palliative because of the progressive nature of the disease in the native vessels and implanted conduits. The patients with previous coronary surgery constitute a very frequent population among the patients who undergo coronary angiography and they posses their own modalities and therapeutic responses.Here we report the angiographic characteristics of 60 consecutive patients with previous coronary artery bypass surgery. The clinical criteria for the angiographic study and the feasibility for determina-ti Qn of the culprit artery of the acute ischemic event were also analyzed. The responsible vessel of the acute ischemic event was recognized in 83% of the patients. In most of them it was related to the native circulation and principally to the left circumflex one. Endoluminal treatment was instituted in 31 of 60 patients.We conclude that within the population of subjects with anginal syndrome and previous coronary artery bypass surgery, the angiographic study al-lowed the identification of the culprit lesion in a high percentage of patients. The left circumflex artery was affected most frequently. An increased number of these patients were successfully treated with endoluminal therapy.