CORONARY-ARTERY BYPASS IN PATIENTS WITH PREVIOUSLY PLACED IMPLANTABLEDEFIBRILLATORS

Four patients with previously placed implantable defibrillators requir e coronary revascularization several years after the original device w as inserted, Three patients had a conventional system of epicardial pa tches and leads, and one patient had a nonthoracotomy system placed. A ll four patients were successfully revascularized without evidence of perioperative infarction or significant morbidity. The patient with th e nonthoracotomy device did require manipulation of the endocardial le ad at a separate setting. This limited experience suggests that patien ts needing revascularization after placement of an implantable defibri llator can be successfully bypassed.