[Invasive treatment in patients with prior coronary artery bypass grafting].

In eight hundred eighty three patients with prior coronary bypass grafting (CABG), cardiac symptoms were recurred in 179 patients in late follow-up period (mean 5 +/- 2.8 years). Of 179 patients, 43 patients had PTCA eventually. In these, 57 times of angioplasties were attempted. Twenty-one lesions in venous bypass grafts and 50 in native coronary arteries were performed, respectively. The initial success rate per bypass graft and per stenosis of native coronary artery were 68% and 74%, respectively. Five patients had elective CABG following failed PTCA. There were no emergency CABG procedures required after unsuccessful PTCA. Intracoronary thrombolysis (ICT) were performed in 13 patients. In these, 15 ICT attempts were made. Nine lesions in venous bypass grafts, 9 for native coronary arteries, and 3 for both were attempted. The primary success rate per occlusion was 67%. Twenty reoperation were done. There was one hospital death and one late death due to congestive heart failure 4 years after the reoperation. In conclusion, invasive treatments in patients with prior CABG can be performed with satisfactory safety and good results. Therefore, invasive treatment should be considered in the patients with CABG if cardiac symptoms are disabling and angiographically suitable lesions are present in the native coronary arteries or vein grafts.