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[Re-operation for myocardial revascularisation. 15 cases (author's transl)]
La Nouvelle Presse Medicale
|December 30, 1978
Summary
Late re-operation for myocardial revascularisation after aorto-coronary bypass can be successful. Follow-up coronary arteriography is recommended for recurrent angina to identify treatable graft lesions.
Area of Science:
- Cardiovascular Surgery
- Interventional Cardiology
- Vascular Surgery
Background:
- Aorto-coronary bypass grafting (ACBG) is a common procedure for coronary artery disease.
- Late graft failure or progression of native coronary disease can lead to recurrent angina.
- Re-operation for myocardial revascularisation presents unique challenges.
Observation:
- Out of 1110 patients, 15 required late re-operation for myocardial revascularisation, with an average interval of 28 months post-initial surgery.
- Re-operations were performed due to recurrent anginal symptoms, occurring approximately 15 months after the first procedure.
- Surgical interventions included six vein graft stenosis resections and eleven new bypass procedures.
Findings:
- The study observed a 10% mortality rate (3 out of 15 patients) associated with late re-operations.
- Of the 12 survivors, 9 remained asymptomatic for 4 to 63 months following the re-operation.
- The procedures aimed to address either localized stenosis in vein grafts or new arterial blockages.
Implications:
- Recurrent angina after ACBG warrants investigation with follow-up coronary arteriography.
- Identifying specific graft or native vessel lesions can guide further surgical intervention.
- Re-operative myocardial revascularisation can offer symptomatic relief and improved outcomes in selected patients.