Percutaneous Interventions in Aortocoronary Saphenous

Percutaneous Interventions in Aortocoronary Saphenous
Order 58970201
Percutaneous Interventions in Aortocoronary Saphenous
1 Which of the following statements about the historical background of surgical revascularization is
true?
(A) Coronary artery bypass grafting (CABG) using
venous conduits was first performed in humans
in the 1960s
(B) The first conduit used was the left internal
mammary artery (LIMA)
(C) The first aortocoronary saphenous vein graft
(SVG) was implanted in humans in the 1950s
(D) SVGs were used as bypass grafts in humans
earlier than LIMA
(E) A and B are true
2 Which of the following statements concerning
patency rate of aortocoronary SVGs is true?
(A) Less than 5% of vein grafts are occluded at 1 year
(B) 20% of vein grafts are occluded at 10 years
(C) 40% of vein grafts are occluded at 10 years
(D) 80% of vein grafts are occluded at 10 years
(E) A and C are true
3 Which of the following statements best describes the
need for further revascularization (redo-CABG or
percutaneous coronary intervention [PCI]) among
patients who had undergone bypass surgery using
SVGs?
(A) Further revascularization is required in approximately 60% of cases at 10 years
(B) Further revascularization is required in approximately 40% of cases at 10 years
(C) Further revascularization is required in approximately 20% of cases at 10 years
(D) Further revascularization is required in approximately 5% of cases at 10 years
4 Which of the following statements about redo-CABG
among patients who had undergone bypass surgery
previously is not correct?
(A) Redo surgery carries a higher mortality rate than
the first CABG
(B) Redo surgery carries a higher morbidity rate than
the first CABG
(C) Redo surgery conveys the same degree of relief
from angina as the first CABG
(D) Redo surgery conveys less relief from angina
than the first CABG
(E) Redo surgery is associated with reduction in SVG
patency as compared with initial surgery
5 A 74-year-old gentleman presents with angina
Canadian Cardiovascular Society (CCS) III 15 years
following CABG. Before coronary angiography, he
wants to know which potential therapeutic options
may be applicable for him:
(A) PCI, if the lesions are suitable
(B) Owing to the nature of graft atherosclerosis,
medical management is the only strategy with
acceptable risk
(C) Redo-CABG is the default approach in these
cases
(D) In patients with advanced SVG-disease, redoCABG should be considered, particularly if no
internal mammary artery (IMA) grafting has
been previously performed
(E) A and D are correct
155
156 900 Questions: An Interventional Cardiology Board Review
6 Which of the following morphologic features is the
least characteristic for vein graft atherosclerosis?
(A) Extensive calcification
(B) Atherosclerotic plaque with poorly developed
fibrous cap
(C) Thrombosis
(D) Neointimal hyperplasia
(E) Diffuse involvement
7 A 75-year-old woman presents with acute coronary
syndrome (ACS) and dynamic ST-segment depression in the lateral leads. She had undergone CABG
4 months earlier (LIMA to left anterior descending
artery [LAD], right internal mammary artery [RIMA]
to right carotid artery [RCA], SVG to the first diagonal branch, and jump-graft to the first marginal
branch of the left circumflex artery [LCX]) and her
preoperative ejection fraction (EF) was 30%. Coronary angiography demonstrated an occlusion of the
SVG to the diagonal branch. Which of the following
statements about early SVG occlusion (i.e., within
the first 6 months of surgery) is true?
(A) A postoperative high graft flow damages the
endothelium and therefore predisposes to early
SVG occlusion
(B) Preoperative congestive heart failure is a significant predictor of early SVG occlusion
(C) Grafting to diagonal branches carries a higher
early SVG occlusion rate compared with other
territories
(D) Female gender is a significant predictor of early
SVG graft occlusion
(E) B and C are correct
8 Which of the following statements about vein graft
thrombosis is not correct?
(A) Vein graft thrombosis is the principal underlying
mechanism of early vein graft occlusion
(B) Bypass surgery is characterized by a prothrombotic state
(C) Even when performed under optimal conditions, harvesting of venous conduits is associated
with focal endothelial cell loss or damage
(D) Reduction of graft flow due to anastomosis
proximal to an atherosclerotic segment or to
a stricture at the anastomosis site predisposes to
graft thrombotic occlusions
(E) Oral anticoagulants are superior to aspirin in
preventing SVG thrombosis
9 A 68-year-old man with diabetes presented with ACS
and dynamic ST depression in the leads V4 through
V6. Eight months earlier, he had undergone CABG
(LIMA to LAD, vein to diagonal branch, and jumpgraft to LCX, vein to RCA). In this patient, the likely
cause for ischemia between 1 month and 1 year
following CABG is:
(A) A stenosis at the distal anastomosis site
(B) A subacute thrombotic graft occlusion
(C) A mid-graft stenosis due to neointimal hyperplasia
(D) A stenosis at the proximal anastomosis due to
aorto-ostial disease
(E) A, B, and C are true