REOPERATION FOR RECURRENT CORONARY-ARTERY DISEASE - RESULTS OF 200 CONSECUTIVE CASES

Background: It is well known that reoperation for recurrent coronary a rtery disease is more difficult than primary coronary artery bypass gr afting. However, it is possible to reduce the morbidity and mortality of reoperation to the same level as the initial procedure with careful surgical technique. Methods: A retrospective study of the first 200 p atients who underwent redo coronary bypass grafting was undertaken. Re sults: In the first 200 cases of redo coronary bypass grafting at St G eorge Hospital, Sydney (August 1986-January 1995), there were five in- hospital deaths (2.5%). There was one case of sternal infection (0.5%) , which required surgical debridement, three cases of stroke (1.5%), o ne case of postoperative bleeding (0.5%), which required a return to t heatre and six cases (3%) required mechanical ventilation for more tha n 24 h. The need for major postoperative support (such as intra-aortic balloon pumping/adrenaline infusion) was significantly affected by th e degree of urgency and the degree of pre-operative ventricular impair ment. Conclusions: The mortality rate of redo coronary artery bypass g rafting in this series is similar to that of primary surgery described in other reports.