Experience and early results of second reoperations for coronary artery disease

Abstract

Should patent vein grafts be replaced during reoperation?Rooperation for coronary artery disease has become a routine procedure; however, a second rooperation is exceptional. In this report we describe our experience with 16 patients undergoing a second rooperation 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 rooperation was usually done for angina because of progression of atherosclerosis in the native coronary system and the second rooperation 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 rooperation and may prevent a second rooperation.

Extraluminal Atherosclerosis: An Under-recognised Finding in Human Aortocoronary Venous Bypass Grafts

“…Clinical characteristics were recorded in predesigned data sheets. In addition to angiographically diseased vein grafts, angiographically patent old vein grafts were also excised when obtaining such grafts were possible and justified by the surgical team [14,15]. After harvesting, the proximal end of the grafts was demarcated and then immediately handed to the study coauthor witnessing the operation.…”