冠状动脉旁路移植术术后患者的冠状动脉介入治疗

Percutaneous coronary intervention in patients with previous coronary artery bypass grafting

目的 探讨冠状动脉旁路移植术 (CABG)术后患者冠状动脉介入治疗 (PCI)的特点。方法 对2 0 0 1年 1月～ 2 0 0 2年 12月我院PCI手术病例登记资料中有CABG史者进行分析。结果 本组共 10例CABG术后施行PCI的患者 ,男 8例 ,女 2例 ,年龄 5 3～ 73岁 ,平均为 (6 5± 7)岁。PCI距CABG手术时间为 0 .5～ 15年 ,平均为 (8± 6 )年。 10例患者共有桥血管 2 6支 ,其中 13支完全闭塞 ,3支有显著性病变。共对其中 12支血管 (14个病变 )行介入治疗 ,其中 9支为原先的自身旁路目标血管 ,2支为旁路目标血管外的自身血管病变进展 ,1支为退变的静脉桥血管。共置入 11枚支架。 10例患者均获得影像学成功 ,住院期间无重大并发症 ,心绞痛症状改善或消失。随访过程中有 2例患者发生严重不良心脏事件。结论 PCI可作为治疗CABG术后心绞痛复发患者的有效方法。

Objective To appraise the characteristics of patients with previous coronary artery bypass grafting(CABG) undergoing percutaneous coronary intervention(PCI). Methods Data were collected as a part of a retrospective registry of all percutaneous coronary interventions performed between January 2001 and December 2002. Results PCI was performed in ten patients with prior CABG. There were 8 males and 2 females with age ranging 53～73 years (65±7). The duration of PCI from previous CABG was 0.5～15 years. Among the 26 grafts, 13 were totally occluded, 3 were significantly stenosed. PCI were successfully performed in 12 vessels, including 9 primary vessels which were the targets of previous CABG, 2 other vessels which were not the targets of prior CABG and 1 saphenous vein graft. 11 stents were implanted. The procedural successful rate was 100% in all 10 patients with abatement or relief of angina pectoris. During follow-up there were 2 major adverse cardiac events. Conclusion PCI is effective for patients with recurrence of symptoms after CABG.