Indications for and risks in reoperation for coronary artery disease

Scand J Thorac Cardiovasc Surg. 1990;24(1):1-6. doi: 10.3109/14017439009101813.

Abstract

Seventy-one coronary artery bypass grafting (CABG) reoperations were performed during a 17-year period, comprising 2.7% of all CABG operations. The main indication (in 87%) was vein graft failure alone or combined with other causes. Progression of disease in native coronary arteries was the sole indication in only 4 of the 71 cases. There were seven perioperative deaths, mainly due to myocardial infarction. Significant perioperative complications arose in 36 cases, including intraoperative lesion of a previous left internal mammary graft (16.2%) or of the right ventricle or anterior descending branch of the left coronary artery (2.8%). Postoperative low output syndrome appeared in 13 patients (18.3%), in seven of whom myocardial infarction was verified. Postoperative bleeding required resternotomy in six cases (9.1%). Because of the heightened operative mortality and morbidity risks, indications for redo CABG should be individualized. A well functioning internal mammary artery graft may be a relative contraindication. Accurate knowledge of the previous operation is essential and, especially in young patients, the possibility of reoperation should be taken into consideration at initial CABG.

MeSH terms

  • Adult
  • Aged
  • Cardiac Output, Low / etiology
  • Coronary Artery Bypass / adverse effects*
  • Coronary Disease / surgery*
  • Female
  • Graft Occlusion, Vascular / etiology
  • Graft Occlusion, Vascular / surgery
  • Hemorrhage / etiology
  • Humans
  • Male
  • Middle Aged
  • Postoperative Complications / surgery*
  • Reoperation
  • Risk Factors
  • Surgical Wound Infection / etiology