Care of the Post-CABG Patient.

Abstract:

:An estimated 400,000 coronary artery bypass graft operations are performed annually in the United States. Saphenous vein grafts are the most commonly used conduits; however, graft failure is common. In contrast, left internal mammary artery grafts have more favorable long-term patency rates. Guidelines recommend aggressive secondary prevention. In the 2 decades following surgery, 16% of patients require repeat revascularization, and percutaneous coronary intervention accounts for 98% of procedures performed. Post-coronary artery bypass graft patients presenting with symptoms of acute coronary syndrome or progressive heart failure should undergo early coronary angiography given the high likelihood that such a presentation represents graft failure. Percutaneous coronary intervention in degenerated saphenous vein grafts is associated with embolization that may cause the "no-reflow phenomenon," which can be avoided with the use of embolic protection devices. Hybrid revascularization procedures are a promising emerging strategy to avoid the placement of vein grafts.

journal_name

Cardiol Rev

journal_title

Cardiology in review

authors

Collins D,Goldberg S

doi

10.1097/CRD.0000000000000261

subject

Has Abstract

pub_date

2020-01-01 00:00:00

pages

26-35

issue

1

eissn

1061-5377

issn

1538-4683

pii

00045415-202001000-00006

journal_volume

28

pub_type

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