Early Coronary Artery Bypass Grafting Following Life-Saving Percutaneous Coronary Intervention

Aim: Percutaneous coronary intervention is usually the initial treatment option for treatment of emergent and severe coronary atherosclerosis with suitable coronary arteries. We aimed to investigate the clinical features, morbidity and mortality rates of coronary artery bypass grafting performed following life-saving stent procedures and patency rates of these stents. Material and Method: Between January 2005 and December 2008, we performed coronary artery bypass grafting on 23 patients who had previous percutaneous coronary intervention to the culprit artery for acute myocardial infarction. Early postoperative coronary angiography was obtained for evaluation of stent patency. Results: In-hospital mortality occurred in five patients (21.7%). Coronary angiographic examination of the remaining patients revealed severe stenosis or occlusion at 16 out 20 stents (80%). The mean time interval between percutaneous coronary intervention and coronary artery bypass grafting was found to be statistically significant regarding stent patency (p=0.007). Discussion: Bypass grafting to a previously stented coronary artery may be the relevant approach even if the angiographic findings are normal, because intraoperative manipulation and systemic effects of cardiopulmonary bypass if used will result in deformity or occlusion of the stent.