Reoperation for Coronary Artery Disease

Abstract

The progressive nature of coronary atherosclerosis together with the increasing number of primary operative procedures for coronary artery disease ultimately increases the number of patients who are candidates for reoperation. Therefore the rate of reoperation for coronary artery disease is on the rise. Irarrazaval et al. [1] report less than 1% of their caseload being reoperations in 1974 versus 3% in 1979, Loop [2] went from 3% in 1969 to 4.5% in 1979, and Schaff [3] reported a 6.2% reoperation rate in 1980. Angina has been reported to recur in patients postoperatively at rates of 3.5% to 7.2% per year [2–5]. Recurrent symptoms can be attributed to narrowing or occlusion of the vein graft, progression of disease in native arteries, diseased but unbypassed arteries at the time of initial operation, or a combination of these factors. During the early years of coronary artery bypass grafting (CABG) the incidence of graft patency was 65%–75% [6]. With further development of the technique and experience the patency rates are now 80%–85% at one year, with an annual attrition rate of 2% [7].