English summary: ANGINA RECURRING AFTER BYPASS SURGERY

Background

An increasing number of coronary angiographies is performed in patients who have been previously treated with coronary bypass surgery. The treatment of this group of patients is not well established.

Methods

All patients who had been previously treated with coronary bypass surgery and were admitted to Oulu University Hospital for coronary angiography during the years 2000-2002 were evaluated retrospectively. Patient characteristics, symptoms and chosen treatments were assessed from the patient files. On the basis of a patient inquiry, symptoms and later morbidity were evaluated after a mean follow-up period of 44 months after the angiography.

Results

72.1% of the patients were treated conservatively. Re-bypass surgery was performed in 9.9% and coronary angioplasty in 15.6%. The mortality rates were 6% and 13% in the conservative and invasive treatment groups, respectively. Severe symptoms and ischaemia in exercise test seem to lead to invasive treatment. The patient inquiry showed that most of the patients were satisfied with the treatment, whether it was conservative or invasive.

Conclusions

Patients with prior bypass surgery and severe angina symptoms should be referred to coronary angiography.

Tästä asiasta tiedettiin

Merkittävä osa kertaalleen ohitusleikatuista potilaista joutuu uuteen sepelvaltimoiden varjoainetutkimukseen palautuneen rintakivun takia. Näiden potilaiden määrä on kasvussa kardiologisessa potilasaineistossa. Tämän potilasryhmän hoidosta Suomessa on vain vähän tutkimustietoa.

Tämä tutkimus opetti

Neljännes varjoainetutkimukseen päätyvistä aiemmin ohitusleikatusta potilaista voidaan hoitaa invasiivisesti. Vaikka valtaosa invasiivisesti hoidetuista kokee hyötyneensä hoidosta, ei potilastyytyväisyydessä ole eroa eri hoitomuotojen välillä.