Percutaneous coronary intervention prior coronary bypass surgery
Percutaneous Coronary Intervention Guidelines Microchapters |
PCI Approaches: |
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CAD Revascularization: |
Pre-procedural Considerations: |
Procedural Considerations: |
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Post-Procedural Considerations: |
Quality and Performance Considerations: |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
ACCF/AHA 2009 Guidelines for Management of Patients with ST-Elevation Myocardial Infarction and Guidelines for Percutaneous Coronary Intervention: PCI in patients with Prior Coronary Bypass Surgery[1] (DO NOT EDIT)
Class I |
"1. When technically feasible, PCI should be performed in patients with early ischemia (usually within 30 days) after CABG. (Level of Evidence: B)" |
"2. It is recommended that distal embolic protection devices be used when technically feasible in patients undergoing PCI to saphenous vein grafts. (Level of Evidence: B)" |
Class III (No Benefit) |
"1. PCI is not recommended in patients with prior CABG for chronic total vein graft occlusions.(Level of Evidence: B)" |
"2. PCI is not recommended in patients who have multiple target lesions with prior CABG and who have multi-vessel disease failure of multiple SVGs, and impaired LV function unless repeat CABG poses excessive risk due to severe comorbid conditions. (Level of Evidence: B)" |
Class IIa |
"1. PCI is reasonable in patients with ischemia that occurs 1 to 3 years after CABG and who have preserved LV function with discrete lesions in graft conduits. (Level of Evidence: B)" |
"2. PCI is reasonable in patients with disabling angina secondary to new disease in a native coronary circulation after CABG. (If angina is not typical, objective evidence of ischemia should be obtained.) (Level of Evidence: B)" |
"3. PCI is reasonable in patients with diseased vein grafts more than 3 years after CABG. (Level of Evidence: B)" |
"4. PCI is reasonable when technically feasible in patients with a patent left internal mammary artery graft who have clinically significant obstructions in other vessels. (Level of Evidence: C)" |
References
- ↑ Kushner FG, Hand M, Smith SC, King SB, Anderson JL, Antman EM, Bailey SR, Bates ER, Blankenship JC, Casey DE, Green LA, Hochman JS, Jacobs AK, Krumholz HM, Morrison DA, Ornato JP, Pearle DL, Peterson ED, Sloan MA, Whitlow PL, Williams DO (2009). "2009 focused updates: ACC/AHA guidelines for the management of patients with ST-elevation myocardial infarction (updating the 2004 guideline and 2007 focused update) and ACC/AHA/SCAI guidelines on percutaneous coronary intervention (updating the 2005 guideline and 2007 focused update) a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines". Journal of the American College of Cardiology. 54 (23): 2205–41. doi:10.1016/j.jacc.2009.10.015. PMID 19942100. Retrieved 2011-12-06. Unknown parameter
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