Update on Cardiac Catheterization in Patients With Prior Coronary Artery Bypass Graft Surgery.

Patients who undergo coronary bypass graft surgery often require subsequent cardiac catheterization and repeat coronary revascularization. Saphenous vein graft lesions have high rates for distal embolization that can be reduced with use of embolic protection devices. They also have high restenosis rates, which are similar with drug-eluting and bare-metal stents. Percutaneous coronary interventions of native coronary arteries is generally preferred over saphenous vein graft interventions, but can often be complex, requiring expertise and specialized equipment. Prolonged dual-antiplatelet therapy and close monitoring can help optimize subsequent clinical outcomes. • Additional revascularization is often needed after coronary artery bypass graft surgery and carries increased risk. • Optimal saphenous vein graft percutaneous coronary intervention requires embolic protection devices and vasodilators. • If feasible, recanalization of the native coronary artery is preferred over bypass graft recanalization. • Novel technical developments and pharmacotherapy are needed to improve outcomes after coronary bypass graft surgery. [ABSTRACT FROM AUTHOR]