Coronary artery reoperations using arterial conduits: immediate and early results.

ABSTRACT

This study deals with results of coronary artery reoperations in 21 males aged 54.4 +/- 6.6 years. Native vessel coronary disease at first and second operation was nearly the same (2.7 +/- 0.6 vs 2.8 +/- 0.4 vessel, p = NS). Graft attrition and deterioration in left ventricular ejection fraction (55.9 +/- 9.2 initial vs 36 +/- 15 at reoperation, p < 0.001) necessitated reoperation in majority. Recurrence of angina (71%) and left ventricular failure (23.8%) were the clinical indicators for reoperation. Procedure was successful in 20 (95%) and had to be abandoned in 1 due to severe pericardial and sternal adhesions. Arterial grafts were utilised in 90% (18 cases, Group A and B). Total arterial revascularisation (Group A) was done in 9 (45%) using Y graft 6, combination of both mammary arteries 2, and by both mammary and inferior epigastric artery in 1. Group B patients had arterial grafts (bilateral IMA 1, Y graft 1, bilateral IMA + gastroepipolic 1, RIMA 4, and LIMA 2) in addition to a venous graft. Two patients (group C, 10%) had only venous grafts. There was no in hospital mortality or morbidity and at 10 +/- 5.2 months follow up, all are asymptomatic with negative stress test at 3 months followup in 8 cases. We conclude that coronary artery reoperations using arterial conduits can be performed safely with excellent immediate and early results.