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A 61-year-old man underwent coronary artery bypass grafting because of severe three-vessel disease. Since he had post-operative anginal attacks, coronary angiography was performed. The examination revealed the right coronary artery (RCA) and left circumflex artery (LCX) to be completely occluded, and the left anterior descending artery (LAD) showed 90% stenosis. Furthermore, the three bypass grafts (to RCA, LCX and LAD) were all occluded. The patient had severe anginal episodes despite drug therapy. Since the patient refused a second bypass operation, we performed percutaneous transluminal coronary angioplasty on the LAD. Subsequently, the stenosis of LAD was reduced to 25%, eliminating subjective episodes of angina pectoris.

Successful coronary angioplasty for the ramaining coronary artery with two completely occluded arteries with prior bypass grafting.