Department of Cardiovascular Surgery, Medicine Faculty, Sakarya University, Sakarya, Turkey.
Department of Cardiovascular Surgery, Sakarya Training and Research Hospital, Sakarya, Turkey.
Braz J Cardiovasc Surg. 2024 May 15;39(4):e20230303. doi: 10.21470/1678-9741-2023-0303.
In this study, we aimed to evaluate the most common causes of recurrent angina after coronary artery bypass grafting (CABG) and our treatment approaches applied in these patients.
We included all patients who underwent CABG, with or without percutaneous coronary intervention after CABG, at our hospital from September 2013 to December 2019. Patients were divided into two groups according to the time of onset of anginal pain after CABG. Forty-five patients (58.16 ± 8.78 years) had recurrent angina in the first postoperative year after CABG and were specified as group I (early recurrence). Group II (late recurrence) comprised 82 patients (58.05 ± 8.95 years) with angina after the first year of CABG.
The mean preoperative left ventricular ejection fraction was 53.22 ± 8.87% in group I, and 54.7 ± 8.58% in group II (P=0.38). No significant difference was registered between groups I and II regarding preoperative angiographic findings (P>0.05). Failed grafts were found in 27.7% (n=28/101) of the grafts in group I as compared to 26.8% (n=51/190) in group II (P>0.05). Twenty-four (53.3%) patients were treated medically in group I, compared with 54 (65.8%) patients in group II (P=0.098). There was a need for intervention in 46.6% (n=21) of group I patients, and in 34.1% (n=28) of group II patients.
Recurrent angina is a complaint that should not be neglected because most of the patients with recurrent angina are diagnosed with either native coronary or graft pathology in coronary angiography performed.
本研究旨在评估冠状动脉旁路移植术后（CABG）复发性心绞痛的最常见原因，以及我们在这些患者中应用的治疗方法。
我们纳入了 2013 年 9 月至 2019 年 12 月在我院接受 CABG 治疗的所有患者，无论其是否在 CABG 后进行经皮冠状动脉介入治疗。根据 CABG 后心绞痛发作的时间，将患者分为两组。45 例患者（58.16±8.78 岁）在 CABG 后第 1 年发生复发性心绞痛，被指定为 I 组（早期复发）。II 组（晚期复发）包括 82 例患者（58.05±8.95 岁），其在 CABG 后第 1 年发生心绞痛。
I 组患者术前左心室射血分数的平均值为 53.22±8.87%，II 组为 54.7±8.58%（P=0.38）。I 组和 II 组患者术前血管造影结果无显著差异（P>0.05）。I 组中 27.7%（n=28/101）的桥血管发生了桥血管闭塞，而 II 组中这一比例为 26.8%（n=51/190）（P>0.05）。I 组中有 24 例（53.3%）患者接受药物治疗，而 II 组中有 54 例（65.8%）患者接受药物治疗（P=0.098）。I 组中有 46.6%（n=21）的患者需要介入治疗，而 II 组中有 34.1%（n=28）的患者需要介入治疗。
复发性心绞痛是一个不容忽视的问题，因为大多数复发性心绞痛患者在进行冠状动脉造影时都被诊断为原发性冠状动脉或桥血管病变。
