Reoperation for recurrent angina.

Abstract

Forty patients with persistent or recurrent angina after an aortocoronary bypass procedure underwent a second operation. The cause of recurrent angina, defined by angiography, was thought to be isolated graft failure in 13 patients, progression of disease in ungrafted vessels in 4, incomplete revascularisation in 2, and stenoses distal to patent grafts in 1. More than one factor was responsible in 20 patients. There was 1 early postoperative death and 3 perioperative myocardial infarctions. Thirty-four patients have been followed for more than 3 months (4 to 63 months). Of these, 17 had previously bypassed vessels regrafted and 5 are sympton free, 4 have mild angina, and 8 have severe angina. Ten patients had previously ungrafted vessels grafted and 4 are sympton free, 3 have mild angina, 2 have severe angina, and 1 is limited by breathlessness. Seven patients had a combined procedure and 4 are sympton free, 1 has mild angina, and 2 have severe angina. Reoperation can be carried out safely but the results are less satisfactory than for a primary procedure.

2011 ACCF/AHA Guideline for Coronary Artery Bypass Graft Surgery

“…The variables associated with decreased late survival rate included advanced age, hypertension, elevated serum cholesterol, diabetes mellitus, PAD, renal failure, left main CAD, LV systolic dysfunction, and emergency status. 1235 Compared with primary CABG, repeat CABG is less successful at relieving angina, 1237,1238 although a 2004 quality-of-life analysis reported that repeat CABG was as effective as primary CABG in relieving angina and improving functional capacity and quality of life. 1239 …”

2011 ACCF/AHA Guideline for Coronary Artery Bypass Graft Surgery

“…A multicenter study from Australia re- (1235). Compared with primary CABG, repeat CABG is less successful at relieving angina (1237,1238), although a 2004 quality-of-life analysis reported that repeat CABG was as effective as primary CABG in relieving angina and improving functional capacity and quality of life (1239).…”

Reoperation for angina after previous aortocoronary bypass surgery.

“…3 The results of reoperations at the London Chest Hospital were reported in 1979. 4 We now report our further experience with a larger series of patients and the results of extended follow up of those who underwent operation initially. We sought to identify factors, which can be determined preoperatively, that may give an indication of the prognosis after reoperation.…”