[Coronary reoperation].
From 1884 to 1997, 24 patients (1.3%) underwent coronary reoperation in a mean of 10.18 +/- 3.35 ears after the first operation at Juntendo University. The mean age of the patients at reoperation was 60.7 +/- 8.0 years. Although 2 patients had received a left internal thoracic artery graft at the primary operation, both grafts were already occluded. At reoperation, 19 patients received at least one internal thoracic artery, and 2 received a gastroepiploic artery graft. The mean number of grafts was 1.96 +/- 0.67 at reoperation. One patient underwent reoperation combined with pseudoaneurysmectomy at the proximal anastomosis site, and one patient reoperation combined with mitral valve replacement. There were 2 in-hospital deaths. The use of an arterial graft to the LAD is recommended at reoperation because of its long-term superiority. Since transmyocardial laser revascularization (TMLR) and minimally invasive direct coronary artery bypass (MIDCAB) at reoperation have recently been reported, these strategies may be considered as useful methods in future.
Hosoda
Y
Y
Department of Cardiothoracic Surgery, Juntendo University School of Medicine, Tokyo, Japan.
Takazawa
K
K
D000328:Adult; D001026:Coronary Artery Bypass / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012086:Reoperation