الفهرس 
Historical backgroundOnly 14 pages are availabe for public view
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Abstract
Objectives: The number of percutaneous coronary interventions
(PCI) prior to coronary artery bypass grafting (CABG) increased drastically
during the last decade. Patients are referred for CABG with more severe
coronary pathology, which may influence postoperative outcome.
Methodology: Outcomes of 200 CABG patients, collected by
prospective multicenter randomized control study, were compared (mean
follow-up: 3 months). Group I (n = 100, mean age 57.20 years, 9 women)
underwent primary CABG and group II (n = 100, mean age 53.25, 18
women) had prior PCI before CABG. In group II, the mean number of
administered stents was 1.98.
Results: Patients with prior PCI presented for CABG with more
severe CAD as evidenced by higher CCS classification score (P = 0.016),
higher incidence of previous myocardial infarction (P = 0.004), unplanned
CABG (P = 0.0000001), and higher mean EDD (P = 0.021). The total
number of grafts was significantly higher in the non PCI group 3.12±0.73 vs.
2.46±0.85 (P value=0.00001), also the incidence of total revascularization
was significantly higher in the non PCI group 79 vs 50 (P value=0.00001).
Postoperative inotropic support usage, overall morbidity and the mean
hospital stay were higher in the PCI group (P value=0.02, 0.01 and 0.000595
repectively). Post operative echo after 3 months showed higher EF (60.20%
±6.28 vs. 58%± 8-P value 0.0001) and better improvement of RSWMA and
dimension (P value =0.0001, 0.048 respectively) in the non PCI group.
Conclusion: Patients with prior PCI presented for CABG with more
severe CAD. Morbidity, were significantly higher in patients with prior PCI
but no difference in mortality. Postoperative echo emphasize lower benefit
from CABG in patents coming with recurrence CAD post PCI.