ANGINA FOLLOWING MYOCARDIAL REVASCULARIZATION - DOES TIME OF RECURRENCE PREDICT ETIOLOGY AND INFLUENCE RESULTS OF OPERATION

  • 1 January 1979
    • journal article
    • research article
    • Vol. 77  (6) , 889-895
Abstract
To assess the operative mortality and long-term results in patients undergoing repeat revascularization for recurrent angina, 48 patients operated on between 1970-1978 were studied. Between 1970 and 1973, 15 patients underwent repeat revascularization with 5 operative deaths (33%) and 33 patients underwent similar operations from 1973 to 1978, with operative death (3%). Technical factors and improved methods of myocardial protection during the operation directly influence this decrease in operative mortality rate. The indication for reoperation was incapacitating angina developing within 2 mo. of the initial operation in 18 patients (early failures) and after more than 2 mo. in 30 patients (late failures). The early failures were most commonly attributed to technical factors (33%) and graft occlusion by exuberant pericardial scarring (33%). The late failures were commonly related to the development of new native coronary lesions (47%) and selection of an incorrect site for distal anastomoses (23%). Prognostic and therapeutic implications of these findings are discussed. Angina was abolished or significantly decreased in 90% of the survivors, and there were 2 late deaths occurring 18 and 20 mo. postoperatively, indicating that patients undergoing repeat myocardial revascularization can be operated on with low operative mortality rates and symptomatic improvement comparable to that of patients undergoing coronary artery bypass for the 1st time.

This publication has 0 references indexed in Scilit: