Favorable impact of stents after emergent coronary artery bypass for failed angioplasty

Background. This study was undertaken to determine the impact of the use and availability of coronary stents on outcomes in patients requiring emergent coronary artery bypass graft (CABG) surgery following a failed percutaneous transluminal coronary angioplasty (PTCA). Methods. Patients were divided into two groups based on the year of their CABG for a failed PTCA and the availability of stents: group 1, 1992 to 1994, stents not available (n = 34); and group 2, 1995 to 1997, stents available (n = 26). Results. CABG patients in the group where stents were not available were more likely to have had an abrupt coronary occlusion (26 of 34 versus 3 of 26; p< 0.0001) and less likely to have had a dissection (8 of 34 versus 23 of 26; p< 0.0001) as their indication for emergent CABG. Patients in the stent era had a lower incidence of perioperative myocardial infarction (5 of 26 versus 17 of 34; p< 0.01) and a decreased mortality rate (0 of 26 versus 6 of 34; p< 0.03). In the 9 patients where stents were employed, patency of the lumen was restored in 8 patients and there was only 1 myocardial infarction. Conclusions. Stents have had a favorable impact on patients requiring an emergent CABG following a failed PTCA.