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Evaluation of a Novel Laser-assisted Coronary Anastomotic Connector - the Trinity Clip - in a Porcine Off-pump Bypass Model
Published on: November 24, 2014
[Percutaneous transluminal coronary angioplasty after coronary artery bypass]
Insights
Percutaneous transluminal angioplasty (PTCA) effectively treats recurrent angina after coronary artery bypass surgery (CABS). This minimally invasive procedure offers a safer alternative to repeat surgery for many patients.
Area of Science:
- Cardiology
- Interventional Cardiology
- Vascular Surgery
Context:
- Recurrent angina can occur years after coronary artery bypass surgery (CABS).
- Causes include graft narrowing, lesion progression, or new coronary artery lesions.
- Repeat CABS carries significant risks of morbidity and mortality.
Purpose:
- To evaluate the efficacy and safety of percutaneous transluminal angioplasty (PTCA) for treating recurrent angina after CABS.
Summary:
- PTCA was performed on bypass grafts or native coronary arteries in 23 patients post-CABS.
- Successful dilation was achieved in 95% of lesions across 91% of patients.
- Mean vessel narrowing reduced significantly (86% to 13%), with improved functional capacity in all successful cases.
Impact:
- PTCA is an effective therapy for recurrent angina post-CABS.
- It presents a preferable alternative to repeat surgery for many patients.
- The procedure demonstrated a low incidence of major complications, with one case of cerebral embolism.
Abstract:
Anginal syndrome may recur early of several years after coronary artery bypass surgery (CABS), and may be due to narrowing of a bypass graft, progression of pre-existing coronary artery lesions, or the appearance of new lesions. Repeat CABS is associated with considerable morbidity and mortality. We therefore performed percutaneous transluminal angioplasty (PTCA) in saphenous or internal mammary bypass grafts or native coronary arteries in 23 patients after CABS. We successfully dilated 35 of 37 lesions (95%) present in 33 of 35 vessels (94%) of 21 of 23 patients (91%). The mean vessel narrowing decreased from 86 +/- 22% to 13 +/- 19% (p less than 0.001) and in all 21 patients with angiographic evidence of success functional capacity improved. Single vein grafts were successfully dilated in 9 patients. None developed acute myocardial infarction or needed emergency surgery, but 1 had a cerebral embolism. PTCA is effective therapy for recurrent angina after CABS, and in many patients is preferable to another operation.
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