Diagnostic and Management Strategies in Patients with Late Recurrent Angina after Coronary Artery Bypass Grafting.
Ruben W de WinterMohammed S RahmanPepijn A van DiemenStefan P SchumacherRuurt A JukemaYvemarie B O SomsenAlbert C van RossumNiels J VeroudenIbrahim DanadRonak DelewiAlexander NapPaul KnaapenPublished in: Current cardiology reports (2022)
Patients with prior CABG often present with late recurrent angina as a result of bypass graft failure and progression of native coronary artery disease (CAD). These patients are generally older, have a higher prevalence of comorbidities, and more complex atherosclerotic lesion morphology compared to CABG-naïve patients. In addition, guideline recommendations are based on studies in which post-CABG patients have been largely excluded. Several invasive and non-invasive diagnostic tools are currently available to assess graft patency, the hemodynamic significance of native CAD progression, left ventricular function, and myocardial viability. Such tools, in particular the latest generation coronary computed tomography angiography, are part of a systematic diagnostic work-up to guide optimal repeat revascularization strategy in patients presenting with late recurrent angina after CABG.
Keyphrases
- coronary artery disease
- coronary artery bypass grafting
- percutaneous coronary intervention
- end stage renal disease
- left ventricular
- coronary artery
- ejection fraction
- chronic kidney disease
- cardiovascular events
- prognostic factors
- peritoneal dialysis
- heart failure
- acute myocardial infarction
- magnetic resonance
- patient reported outcomes
- magnetic resonance imaging
- computed tomography
- physical activity
- cardiovascular disease
- patient reported