Problems of performing coronary artery bypass grafting after preliminary stenting of coronary arteries due to acute coronary syndrome (review of literature)

Abstract

The objective of this article was to analyze current researches on the peculiarities of performing coronary artery bypass grafting in patients who primarily underwent intraluminal angioplasty and stenting due to acute coronary syndrome. Despite the priority of stenting in patients with acute coronary syndrome (ACS), there is still a significant number of unresolved issues in this category of patients, especially when these patients, previously stenting due to ACS, undergo coronary artery bypass grafting due to a repeated ACS case. The tactics of management and preparation of patients who were admitted for repeated CABG after preliminary stenting are still not clear, and therefore, a significant number of unresolved issues remains when performing CABG against the background of repeated ACS cases with a previously compromised vascular bed and the presence of chronic inflammation in the coronary arteries. Questions about the perioperative and postoperative complications in this category of patients remain open. We analyzed the latest works and researches about that problem using such systems as NLM, Google Scholar and Elibrary. Due to the current situation of mass use of stenting, a number of questions remain open (the time of cancellation of double disaggregation therapy, the need for shunting the previously stented vessel, the possibility of performing a combined method of treatment for ACS). There is a very little information on the need to bypass the previously stented coronary artery at an earlier date than indicated in the European recommendations.

Keywords

• acute coronary syndrome
• coronary artery bypass graft
• double disaggregation therapy
• percutaneous coronary intervention
• coronary heart disease