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J Thorac Cardiovasc Surg 1994;107:684-689
© 1994 Mosby, Inc.

SURGERY FOR ACQUIRED HEART DISEASE

Experience and early results of second reoperations for coronary artery diseaseShould patent vein grafts be replaced during reoperation?

L. Noyez, MDa, T. van der Werf, MDb, T. J. Klinkenberg, MDa, D. P. B. Janssen, MDa, G. L. Kaan, MDa, L. K. Lacquet, MDa


Nijmegen, The Netherlands

Received for publication Feb. 26, 1993. Accepted for publication Aug. 17, 1993. Address for reprints: L. Noyez, MD, Department of Thoracic and Cardiac Surgery, University Hospital Nijmegen St. Radboud, Postbus 9101, 6500 HB Nijmegen, The Netherlands.

Abstract

Reoperation for coronary artery disease has become a routine procedure; however, a second reoperation is exceptional. In this report we describe our experience with 16 patients undergoing a second reoperation for coronary atherosclerosis. The absence of operative mortality is certainly related to the patient selection. The number of patients is still too small to draw major conclusions. Striking, however, is that the first reoperation was usually done for angina because of progression of atherosclerosis in the native coronary system and the second reoperation was done because of graft failure. This experience supports the idea that the replacement of old, even patent, venous grafts and the choice of the best available conduits are of great importance at the first reoperation and may prevent a second reoperation. (J THORACCARDIOVASCSURG1994;107:684-9)




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