Natalie Rivas

Article Summary
Biology 1615
4/6/16
There have been recent studies on the successes and failures of percutaneous
coronary intervention and coronary artery bypass grafting. Over the past few years
patients that received successful PCI due to there ischemic heart disease, were later
referred to CABG. Studies show that this occurred due to failure of PCI or because the
native disease had progressed again. Due to the increasing number of patients being
referred to CABG, there were studies done on 2,358 patients in Egypt and Saudi Arabia.
These patients were separated into two groups and both groups underwent CABG.
There were 492 patients in the first group. These patients had successful PCI in
the past, but had recurrent symptoms which led to a requirement of CABG. The second
group had 1866 patients that had only been treated with CABG without prior PCI. Each
patient had a follow-up after being discharged from the hospital which included, a
clinical evaluation, laboratory evaluations, plain chest x-ray, and echocardiography.
Patients that receive PCI and CABG are usually patients with coronary heart disease.
This is caused by the buildup of plaque. Coronary artery disease limits the amount of
blood flow to the heart and it could lead to death. Some of the symptoms of this disease
are chest pain and in some cases heart attacks.
CABG and PCI had been known as the primary treatments for coronary artery
disease. It was believed that CABG without prior PCI would be better than patients that
underwent PCI first. In both groups, all the procedures were performed using full
median sternotomy. A main factor that affected many patients was their age. The

second group that underwent CABG resulted in most patients having post-operative
bleeding.
The results did not really match up with what was expected to happen. The
second group of people was predicted to have better results than the first group. They
predicted this would happen because of the increasing number of people being referred
to CABG due to complications after PCI. The second group of people that only went
through CABG had postoperative bleeding and some complications which was not
expected. It all resulted in CABG having almost the same complications as patients that
received CABG after they underwent PCI.
In conclusion, patients that had coronary heart disease and were given PCI were
later referred to CABG. This was due to the recurring symptoms of the heart disease.
There was not a clear reason why PCI was not working successfully over time and why
CABG was. The results of this experiment was that PCI before CABG lead to a higher
rate of death after the operation. Receiving CABG after PCI is really risky and the
patients receiving this surgery might have more risks after the operation. The results
were different then what was expected in the hypothesis. The whole point was to see if
receiving CABG first would be better than receiving PCI first.