The benefit patients derive from aortocoronary reoperation

There is an increasing incidence of aorto coronary reoperation necessitated by intractable angina which averages 2% of 4676 initial bypass procedures. Graft obliteration, graft stenosis or progression of disease led to recurrence of symptoms in 96 patients (84 male, 12 female) who underwent a second operation. Not all occluded or stenotic bypasses were feasible for reoperation. Hospital mortality (30 days) was higher than after initial CABG, but could be reduced from 12.1% to 4.8%. Subjective and objective follow-up investigations were obtained in 77 of 84 survivors and demonstrate that successful reoperation is about 10% lower in patients with a malignant form of atherosclerosis (60%) than in patients who only suffer from occluded grafts or new proximal significant stenoses in previously unbypassed vessels (70%).