Discussion:
Even though results have been steadily improving, CABG is linked to
significant morbidity, which has a severe impact on long-term standard
of living [1]. When coronary artery bypass grafting (CABG) is used
to treat coronary artery disease in conjunction with aortic valve
replacement (AVR), long-term survival is improved with tolerable
morbidity and mortality [2].
In this instance, the patient had a CABG 13 years prior, and a few years
later she began experiencing complications including dyspnea, chest
discomfort, prolonged need for mechanical ventilation, and vascular and
pulmonary issues. Ostial LAD stenosis was discovered by angiogram, which
accounts for the patient’s respiratory and cardiac difficulties.
Angiogram showed proximal LAD stenosis. Numerous investigations have
revealed that lesions in the distal or proximal arteries of the left
anterior descending (LAD) are more likely to experience restenosis
[3][4].
It is uncertain if the patient’s present condition, which includes
ostial LAD stenosis, is the result of improper stent placement during
angioplasty or for some other cause. In both the short- and long-term,
percutaneous revascularization of the proximal left anterior descending
coronary artery combined with the placement of drug-eluting stents is a
safe and very effective therapeutic approach [3]. Maintaining the
balloon in the LM to LCX while inserting the LAD ostial stent is
extremely beneficial and may be used in clinical practice [5].
Since the patient has also developed acute coronary syndrome (ACS),
immediate PCI is required. Ostial LAD stenting may be a safe,
practicable procedure with a reasonable clinical result. Further
prospective studies are needed to ascertain the impact on long-term
prognosis following coronary bypass surgery, which has a number of
problems but does not result in a greater death rate.