[Angioplasty for vein grafts and native coronary arteries after previous coronary artery bypass grafting]. 1995

S Avital, and R Wacksman, and Y Rozenman, and M Mosseri, and C Lotan, and Y Hasin, and M S Gotsman
Cardiology Dept., Hadassah--Hebrew University Hospital, Ein Kerem, Jerusalem.

219 patients after previous coronary artery bypass grafting (CABG) underwent coronary artery or vein graft angioplasty in 1984-1991. 452 stenotic lesions out of 498 were successfully dilated in 337 procedures (90.7%). For arterial lesions the initial success rate had been 89.2% (321/360) and for vein graft lesions 94.9% (131/138). For repeated angioplasty the success rate was the same. Major complications included 3 deaths (0.9%). 15 myocardial infarctions (5.3%) and 1 emergency CABG. Factors that had reduced the success rate were lesions at the proximal anastomosis, total occlusions, and complex (type C) lesions. Time since grafting did not affect success rate of the second procedure. Restenosis after successful angioplasty was 37.3% (34/91) for arterial lesions and 56.8% (25/44) for graft lesions, after a mean time of 11.2 +/- 2.7 months. Restenosis was more common in type C lesions and old vein grafts. There was considerable improvement in treadmill exercise time of patients after the angioplasty (5.92 vs 7.31 minutes) and in double product. During a follow up of about 3 years, 7.6% (15/196) died of cardiac events, 5.2% (10/189) had myocardial infarctions, 10.5% (20/189) were reoperated and 31.0% (68/219) needed at least 1 repeat angioplasty. Long term followup was better after angioplasty of native arteries than of grafts. After angioplasty of vein grafts, there were more cardiac related deaths, more MIs and more reoperations than after angioplasty of native arteries: 11.5% vs 3.5%, 9.6% vs 2.8%, 21% vs 4.9%, respectively, than in the arterial group. Considering the high mortality and morbidity of reoperation, balloon angioplasty in selected patients may be the preferred strategy. Clinical and angiographic results are better after re-angioplasty of native arteries than vein grafts.

UI MeSH Term Description Entries
D005500 Follow-Up Studies Studies in which individuals or populations are followed to assess the outcome of exposures, procedures, or effects of a characteristic, e.g., occurrence of disease. Followup Studies,Follow Up Studies,Follow-Up Study,Followup Study,Studies, Follow-Up,Studies, Followup,Study, Follow-Up,Study, Followup
D006083 Graft Occlusion, Vascular Obstruction of flow in biological or prosthetic vascular grafts. Graft Restenosis, Vascular,Vascular Graft Occlusion,Vascular Graft Restenosis,Graft Restenoses, Vascular,Occlusion, Vascular Graft,Restenosis, Vascular Graft
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D001026 Coronary Artery Bypass Surgical therapy of ischemic coronary artery disease achieved by grafting a section of saphenous vein, internal mammary artery, or other substitute between the aorta and the obstructed coronary artery distal to the obstructive lesion. Aortocoronary Bypass,Bypass, Coronary Artery,Bypass Surgery, Coronary Artery,Coronary Artery Bypass Grafting,Coronary Artery Bypass Surgery,Aortocoronary Bypasses,Artery Bypass, Coronary,Artery Bypasses, Coronary,Bypass, Aortocoronary,Bypasses, Aortocoronary,Bypasses, Coronary Artery,Coronary Artery Bypasses
D001158 Arteries The vessels carrying blood away from the heart. Artery
D014680 Veins The vessels carrying blood away from the CAPILLARY BEDS. Vein
D015906 Angioplasty, Balloon, Coronary Dilation of an occluded coronary artery (or arteries) by means of a balloon catheter to restore myocardial blood supply. Angioplasty, Coronary Balloon,Angioplasty, Transluminal, Percutaneous Coronary,Coronary Angioplasty, Transluminal Balloon,Percutaneous Transluminal Coronary Angioplasty,Balloon Dilation, Coronary Artery,Transluminal Coronary Balloon Dilation,Angioplasties, Coronary Balloon,Balloon Angioplasties, Coronary,Balloon Angioplasty, Coronary,Coronary Balloon Angioplasties,Coronary Balloon Angioplasty

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