Myocardial infarction after CABG

Abstract

Coronary artery bypass graft (CABG) surgery leads to postoperative relief from symptoms in patients with angina pectoris. However, the incidence for myocardial infarction (MI) after CABG surgery is 6.6 % and it has an estimated rate of mortality ranging from 0.5 to 14 % because it is diffi cult to diagnose and to treat. The most common cause of MI that occurs in the perioperative period is a surgical technical problem, usually related to the graft anastomotic sites, and several years after surgery the progressive atherosclerosis and plaque rupture is the most common phenomenon that leads to the occlusion of the grafts. The treatment of MI after CABG surgery involves a multidisciplinary team (Heart Team) made up of clinical cardiologist, cardiac surgeon, and interventional cardiologist because it is a multidisciplinary decision-making process. They will analyze and interpret the available diagnostic evidence and will decide, in the clinical context of the patient condition, if either percutaneous coronary intervention (PCI) or CABG will be performed. The correction of atherosclerosis risk factors and the development of diagnosis and treatment technique have improved the short- and long-term prognoses in patients with MI and CABG history.