[Abstract] [Full Text PDF] (in Japanese / 2818KB) [Members Only And Two Factor Auth.]

J.Jpn. Surg. Soc.. 99(2): 105-109, 1998


Feature topic

CORONARY REOPERATION

Department of Cardiothoracic Surgery, Juntendo University School of Medicine, Tokyo, Japan

Yasuyuki Hosoda, Kenji Takazawa

From 1884 to 1997, 24 patients (1.3%) underwent coronary reoperation in a mean of 10.18±3.35 years 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 recommeded at reoperation because of its long-term superiority. Since transmyocardial laser revascularization (TMLR) and minlmally invasive direct coronary artery bypass (MIDCAB) at reoperation have recently been reported, these strategies may be considered as useful methods in future.


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