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John J. Collins, Jr.
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Ann Thorac Surg 1977;23:9-13
© 1977 The Society of Thoracic Surgeons

Articles

Results of Reoperation for Recurrent Angina Pectoris

William I. Norwood, M.D., Lawrence H. Cohn, M.D., John J. Collins, Jr., M.D.*

Department of Surgery, Harvard Medical School, and the Division of Thoracic and Cardiac Surgery, Peter Bent Brigham Hospital, Boston, MA.

Accepted for publication April 15, 1976.

* Address reprint requests to Dr. Collins, Chief, Division of Thoracic and Cardiac Surgery, Peter Bent Brigham Hospital, 721 Huntington Ave, Boston, MA 02115.

Although a coronary bypass operation improves the quality of life and possibly prolongs it, a small percentage of patients do not have satisfactory results and require reoperation. From July, 1970, to March, 1975, 358 patients underwent coronary bypass for chronic disabling or preinfarction angina. Angina requiring operation recurred in 24 men and 2 women. Hyperlipoproteinemia was present in 19 of the 26 (73%), and 3 patients had early-onset diabetes mellitus.

Only 2 of 14 patients with progression of arteriosclerosis were helped by a second operation. Of 7 patients with occluded grafts, local disease, and no progression, 5 were helped by reoperation.

Patients with occluded coronary bypass grafts without progression of arteriosclerosis benefit substantially from a second revascularization procedure. A guarded prognosis must be held, however, for those with progression of arteriosclerosis with hyperlipoproteinemia or juvenile-onset diabetes who undergo reoperation. Patients with initially diffuse disease and graft occlusion also seem to benefit less from a second operation.




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