PTCA IN POST CABG PATIENTS PRESENTING WITH ACS: EXPERIENCE FROM A TERITARY CARE CENTRE.

Background: Due to an expanding population of patients with surgically treated coronary artery disease and the natural progression, of atherosclerosis, an increasing number of patients with previous CABG require repeat revascularization procedures. To know the Aim: presentation, angiographic findings and feasibility of PTCA in Post CABG patients who presented with ACS. The present Methods And Results : study was a retrospective analysis of data available in the department of cardiology, Kalinga institute of medical sciences, a teritary care centre. During 2017 - 2022, 113 patients who previously underwent CABG and now presented with ACS were enrolled. Mean time of presentation after CABG was 6.7 years. Mean age was 58.63 years. Presentation was STEMI, NSTEMI, USA in 23 (20.35%), 55 (48.68%), 35 (30.97%) respectively. After CAG, PTCA, medical management and re CABG were adviced for 89 (78.76%), 20 (17.70%) 4 (3.54%) patients respectively. In 89 patients who were adviced for PTCA, at CAG, 128 lesions were identified, 112 (87.5%) in native vessels with total and subtotal occlusion present in 29 (22.65%) and 21(16.40%) patients in LAD, 22(17.19%) and 16 (12.5%) in RCA, 13(10.15%) and 11(8.59 %) in LCX respectively. 13 (10.10%) had lesion in SVG graft. 3 (2.35% ) had lesion in LIMA graft. PTCA was attempted in all the 128 lesions, with DES. 98 lesions (76.5%) were successfully revascularized with PTCA. Procedural failure in native vessels may be attributed to inability to cross the CTOs, heavily calcified vessels. Lesions in graft vessels where revascularized with ease when compared to native vessels. P Conclusion: TCA in patients with post CABG status who presented with ACS, was successful with minimal procedural complications. PTCA may be considered in this special population where redo surgery was associated with significant mortality.