Immediate and Long-term Results of Percutaneous Coronary Intervention in Patients after Coronary Artery Bypass Grafting Using Intraoperative Angiography

Material and methods. We analyzed the immediate results of PCI in 83 patients and long-term results in 59 (71,1%) patients due to the dysfunction previously imposed grafts, who underwent CABG and intraoperative angiography (IA) from 2009 to 2016. Eighty tree patients were imposed 196 (2,3+ 0,8 in average for one patient) grafts.

Results. During IA, dysfunction was found in 62 (31,6%) of 196 grafts (42 of 83 patients, respectively), among them in 44 (71%) cases we registered a significant lumen narrowing with no significant effect on hemodynamic which were not fixed by a cardiac surgeon, and in 18 (29%) cases – possible predictors of graft dysfunction in long-term follow-up. During the period from 1 to 64 months after CABG dysfunction were registered in 91 (46,4%) grafts in 55 patients. Out of 62 dysfunctional grafts revealed during IA, 54 were occluded during the observation period (OR=17,25; Cl (5,46;54,53).

Out of the 91 problem grafts in the long-term follow-up period in 64 (70,3%) - PCI was performed on the after CABG artery (11 - on the grafts, 53 - on the native arteries) and in 36 - PCI on non-grafted coronary arteries.

Long-term patency results we examined in 59 (71,1%) patients. Observation period was from 12 to 60 month after PCI. In 7 (11,9%) patients of 59 in stent restenosis was registered. In 5 (8,5%) secondary PCI was performed

Conclusions.

The immediate clinical success was about 95,2% - OR=21,58; Cl (9.56;48,69), angiographic success was 96,4%. The long-term clinical success was about 81,6% - OR=19,19; Cl (7.57;48,63).Taking into account the reliability of the results,patientswithgraftand/oranastomosissitestenosismorethan 50%,alsoifdysfunctionpredictorsarepresentduringIA –itiscrucialtoperformaintraoperativecorrectionofthiscomplications.