EXPERIENCE AND EARLY RESULTS OF 2ND REOPERATIONS FOR CORONARY-ARTERY DISEASE - SHOULD PATENT VEIN GRAFTS BE REPLACED DURING REOPERATION

Reoperation for coronary artery disease has become a routine procedure ; however, a second reoperation is exceptional. In this report we desc ribe our experience with 16 patients undergoing a second reoperation f or coronary atherosclerosis. The absence of operative mortality is cer tainly related to the patient selection. The number of patients is sti ll 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 reoper ation was done because of graft failure. This experience supports the idea that the replacement of old, even patent, venous grafts and the c hoice of the best available conduits are of great importance at the fi rst reoperation and may prevent a second reoperation.