Outcome of Percoutaneous Coronary Intervention in Patients With Prior Coronary Artery Bypass Surgery

Background: Advance progression in percutaneous coronary intervention (PCI) technique, particularly with new advanced drug elutedstents (DES) has made it an effective treatment for many cardiac diseases. Objectives: Redo coronary artery bypass surgery (CABG) has higher risk of mortality rather than first operation. Although the positiveimpression of percoutaneous coronary intervention (PCI) in such symptomatic patents has not proven yet, but different studies haveevaluated the outcome of the symptomatic post CABG patients after performing PCI. In this study we aim to find out if PCI could be helpfulin such patients. Patients and Methods: In this study, 111 symptomatic patients with pervious history of single coronary artery bypass graft (withoutconcomitant vale surgery) underwent PCI by a single operator between March 2008 and March 2012. Then, they were followed duringthe following year after PCI and the incidence of death redo CABG, persistent cardiac symptom and rate of hospitalization were recorded Results: The successful rate of PCI in this study was estimated to be 94.5% (104 of 111). In hospital MACE was 9.6% (three deaths and onemyocardial infarction). 67% (73) of patients were male and 33% (33) were female. 79.6% (86) of PCI procedures were done on native coronaryarteries and 20.4% (22) on SVG grafts. During one year follow up, we had 7 death in patients with PCI on native vessels (group A) and 1 deathin the patients whose PCI was performed on SVG grafts (group B), (P ≥ 0.999). In group A, 27.9% (24) patients were remained symptomatic;while in group B, 18.4% (4) patients were still symptomatic (P = 0.353). Hospitalization because of cardiac syndrome was recorded for 10.5%(9) patients in group A and 9.1% (2) patients of group B (P > 0.955). None of the patients of group B went under redo-CABG during the followup but 2.3% (2) patients of group A did (P > 0.289). No case of stent restenosis or target vessel revascularization was recorded in either group.The overall rate of death was 7.6% (8 0f 104), persistent cardiac symptoms 27% (28 0f 104), hospitalization for cardiac symptoms 10.5% (11 f14) and redo CABG 2% (2 of 104). Conclusions: This study shows that PCI in symptomatic post CABG patients follows by high successful and low complication rate andpositive impression on their cardiac symptoms and could reduce the need for redo CABG. It seems that there is no difference that PCI isperforming on SVG or native vessel, the intervention itself improves the patients’ quality of life.

Keywords:

Percutaneous Coronary Intervention , Mace , Coronary Artery Bypass Surgery