Reoperation for recurrent coronary artery disease: results of 200 consecutive cases.

BACKGROUND It is well known that reoperation for recurrent coronary artery disease is more difficult than primary coronary artery bypass grafting. 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 patients who underwent redo coronary bypass grafting was undertaken. RESULTS In the first 200 cases of redo coronary bypass grafting at St George 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%), one case of postoperative bleeding (0.5%), which required a return to theatre and six cases (3%) required mechanical ventilation for more than 24 h. The need for major postoperative support (such as intra-aortic balloon pumping/adrenaline infusion) was significantly affected by the degree of urgency and the degree of pre-operative ventricular impairment. CONCLUSIONS The mortality rate of redo coronary artery bypass grafting in this series is similar to that of primary surgery described in other reports.