Recycling of arterial grafts during reoperative coronary artery operations

Background. To overcome problems of lack of conduit and to maximize the num ber of arterial anastomoses in coronary reoperations we reused previously p laced arterial grafts. Methods. Sixteen patients were identified from February 1994 to July 1997. Mean age was 62.8 years (range, 44 to 75 years). Fifteen (94%) were in Cana dian Cardiovascular Society angina class III or IV. The mean interval from primary to secondary operation was 8.5 years (range, 3 to 12 years). Eleven patients had a patent internal mammary artery graft used as the recipient for a proximal Y anastomosis. In 3 cases an arterial graft was reimplanted distally on the same coronary vessel and in 2 onto different coronary vesse ls. One patient had a combination of these techniques. Five patients requir ed venous conduit. Results. There were no deaths. Mean length of intensive care stay was 69 ho urs (range, 24 to 144) and mean hospital stay was 14 days (range, 10 to 28 days). All patients were discharged home. Follow-up averages 13 months (ran ge, 2 to 43 months). Twelve patients (75%) are now in Canadian Cardiovascul ar Society angina class I and 3 (19%) in class II. Conclusions. Reusing arterial conduits during coronary reoperations is poss ible with minimal in-hospital morbidity and satisfactory results in terms o f freedom from angina. Using these techniques can help overcome the problem s of inadequate conduit and maximize the number of arterial anastomoses tha t can be made per patient. (Ann Thorac Surg 1999;67:641-4) (C) 1999 by The Society of Thoracic Surgeons.