Clinical and angiographic features of patients with recurrent angina pectoris after direct myocardial revascularization

The study aimed to identify and evaluate patients’ clinical and angiographic features with recurrent angina pectoris after coronary artery bypass grafting. We examined 113 patients. The total number of shunts was 275, of which 101 were autoarterial (internal thoracic artery in situ), 174 were autovenous. The median of the postoperative period was 58 [48, 75] months. In 51 patients (45.1%; 95% CI 37.8-55.9%), dysfunction of one or more conduits was revealed. The total number of failed shunts was 66 (24%; 95% CI 19.3-29.4%), dysfunction of autovenous conduits was observed 2.6 times more often than autoarterial ones (p<0.001). In most cases, the lesion was occlusive, and its prevalence was significantly higher in patients with accute forms of coronary heart disease (p=0.007). Despite the high incidence of coronary bypass dysfunction, early treatment and timely percutaneous intervention allow angioplasty and graft or coronary artery stenting to be performed in more than 77% of cases with good angiographic and clinical results. The impossibility of endovascular revascularization, as a rule, is determined by a chronic occlusive lesion of the anterior interventricular branch and/or shunt to it, which may require repeated coronary bypass grafting.

repeated revascularization, relapse of angina pectoris, coronary artery bypass grafting, percutaneous coronary intervention, coronary artery bypass grafting