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Ahmed Salah, M.D. is an invasive cardiologist at National Heart Insitute , Cairo , Egypt. He has also special interest at ischemic heart failure PTs, and wheather medical management alone or interventions plus medical management could improve cardiac conditions and function and improve mode of life , He worked at many institutions in Egypt , The Egyheart centre for cardiology and cardiac intervention. He received a training on myocardial viability at nuclear department at Technical university Hospital , Munich, Germany. He is now the Head of interventional cardiology department of MD Hospital , a hospital well established since 1956 , at Alkhobar City , Eastern proviance , Saudi Arabia.
Post CABG recurrent ischemia , are classified into Early & Late according to time of presentation, Each of them has its distinguished ertiology, and mode of management Management depends lagely upon, mode of presentation , either acute or chronic, but medical and interventional techniques are still the options we do have Intervention of such cases depends largely on, number of available grafts, extent and severity of new ischic episode, and location of lesions. Clinical condition of PT, myocardial functions, and viability, and the fully equipped centre with expertise of service providers are all important factors that determine the outcome , morbidity and mortality. The present case was an example of late Post CABG acute ischemia presented with NSTEMI, Hypotension, Cardiogenic shock, recurrent cardiac arrest VT, VF, so, medical hemodynamic support with rapid intervention decision were the only proposed steps that seemed to save PTs life, support PT hemodynamics, and finally resolve the problem.