Hjelms E, Kjaergard H
Department of Cardiothoracic Surgery, Rigshospitalet, Copenhagen, Denmark.
Scand J Thorac Cardiovasc Surg. 1991;25(2):133-5. doi: 10.3109/14017439109098097.
In 1981-1989 we performed repeat coronary artery bypass grafting on 42 men and 10 women (mean age 55 years) with angina pectoris recurring on average 27 months after the primary operation. The cause was occlusion or stenosis of vein grafts alone (59%) or in combination with progression of native coronary atherosclerosis (31%) or progression in the native circulation without graft failure (10%). Complications at the repeat operation included five lesions of the right ventricle and five lesions of patient grafts. The 30-day mortality was 3.8% (95% confidence limits 0.5-13.2%). Survival after observation averaging 2 1/2 years was 92.3% (95% confidence limits 81.5-97.9%). Angina pectoris was completely relieved after the operation in 48% of the patients, lessened in 35% and unchanged in 17%. Although repeat coronary artery bypass grafting carries heightened mortality and morbidity, and the results are less satisfactory than after first-time bypass, the operation can be worthwhile.
1981年至1989年期间，我们对42名男性和10名女性（平均年龄55岁）进行了再次冠状动脉搭桥手术，这些患者在初次手术后平均27个月出现复发性心绞痛。病因是单纯静脉移植物闭塞或狭窄（59%），或与自身冠状动脉粥样硬化进展并存（31%），或自身循环进展而无移植物失败（10%）。再次手术的并发症包括5例右心室损伤和5例患者移植物损伤。30天死亡率为3.8%（95%置信区间0.5 - 13.2%）。平均观察2.5年后的生存率为92.3%（95%置信区间81.5 - 97.9%）。48%的患者术后心绞痛完全缓解，35%减轻，17%无变化。尽管再次冠状动脉搭桥手术死亡率和发病率较高，且结果不如首次搭桥，但该手术仍可能是值得的。
