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Retrograde application of the buddy wire technique.
David Henderson1, Brendan Gunalingam
1Gosford Hospital, Gosford, NSW, Australia.
Summary
An 85-year-old man experienced worsening shortness of breath after coronary artery bypass surgery. A narrowed graft connection was successfully treated using a specialized percutaneous coronary intervention technique.
Area of Science:
- Cardiology
- Interventional Cardiology
- Vascular Surgery
Background:
- Coronary artery bypass grafting (CABG) is a common surgical procedure for severe coronary artery disease.
- Graft failure, including anastomotic strictures, can occur post-CABG, leading to symptom recurrence.
- Radial artery grafts are increasingly used in CABG procedures.
Observation:
- An 85-year-old male presented with progressive exertional dyspnea 18 months post-CABG.
- Coronary angiography identified a critical anastomotic stricture involving a radial artery graft to the first diagonal branch.
- The patient had undergone surgery for critical three-vessel coronary artery disease.
Findings:
- Percutaneous coronary intervention (PCI) was performed to address the anastomotic stricture.
- A retrograde "buddy" wire technique was successfully employed during the PCI procedure.
- This intervention aimed to restore graft patency and alleviate the patient's symptoms.
Implications:
- The case highlights a potential complication of radial artery grafts used in CABG.
- Successful retrograde PCI with a "buddy" wire technique offers a viable treatment option for complex anastomotic strictures.
- This approach may improve outcomes for patients experiencing graft-related symptoms after bypass surgery.
