Mr. Thai previously had severe narrowing of his left anterior descending artery and circumflex artery, necessitating stent placement at a hospital three years ago. Following the intervention, he consistently took medication and attended follow-up appointments, maintaining stable health. One month ago, he began experiencing chest pain during exertion, prompting him to seek examination at Tam Anh General Hospital, TP HCM.

Dr. Huynh Hoang Khang, Head of Cardiovascular Surgery, Interventional Cardiology Center, reported that both of the patient's stents were completely blocked, and his right coronary artery was 70-80% narrowed. This is a typical manifestation of progressive coronary artery disease, where damage extends beyond the stented areas to other branches. The patient presented with complex multi-vessel coronary artery disease, making further stent intervention unsuitable. The optimal approach was bypass surgery to re-establish blood flow to the heart muscle.

The surgical team opted for off-pump coronary artery bypass grafting (CABG) for the patient, which allows for surgery on the coronary arteries without stopping the heart. According to Dr. Khang, compared to traditional methods that require the heart to be stopped throughout the procedure, the off-pump technique offers several advantages. These include reducing systemic inflammatory responses, minimizing the risk of stroke, arrhythmia, and other postoperative complications, while also supporting faster patient recovery.

The surgical team performed bypass surgery to reopen three coronary branches for the patient. Photo: Tam Anh General Hospital

During the approximately 4-hour operation, the team used the patient's own internal mammary artery to create three bypasses, restoring blood flow to the three narrowed coronary branches.

One day after the intervention, the patient engaged in light activity and no longer experienced severe chest pain. He was discharged after seven days.

Coronary artery disease, also known as coronary heart disease, is a condition where the main blood vessels supplying the heart become narrowed or blocked due to atherosclerotic plaque, reducing blood flow to the heart. It is a common cardiovascular disease that can lead to dangerous complications such as heart failure, valvular heart disease, arrhythmia, myocardial infarction, and sudden cardiac death.

According to Dr. Khang, stents only address narrowing at a specific site, whereas atherosclerosis is a progressive systemic process. Over time, plaque can continue to develop, causing narrowing or blockage at the previously stented site (in-stent restenosis) or in other segments of the arteries.

The risk of stent blockage also increases if patients do not effectively manage risk factors such as hypertension, diabetes, dyslipidemia, smoking, overweight, sedentary lifestyle, or non-adherence to treatment. Consequently, some patients who have undergone intervention may still require re-treatment, or even surgery, as in Mr. Thai's case.

Patients who have successfully received stents must adhere to long-term treatment, including antiplatelet medication, control of blood lipids, blood pressure, blood sugar, and maintenance of a healthy lifestyle. Regular follow-up examinations are also important for early detection of restenosis or new lesions.

Thu Ha

*Patient's name has been changed