Weinhold C, Neumaier P S, Klinner W
Department of Cardiovascular Surgery, University Hospital, Grosshadern, Munich, FRG.
Thorac Cardiovasc Surg. 1988 Oct;36(5):266-8. doi: 10.1055/s-2007-1020093.
There is an increasing incidence of aorto coronary reoperation necessitated by intractable angina which averages 2% of 4676 initial bypass procedures. Graft obliteration, graft stenosis or progression of disease led to recurrence of symptoms in 96 patients (84 male, 12 female) who underwent a second operation. Not all occluded or stenotic bypasses were feasible for reoperation. Hospital mortality (30 days) was higher than after initial CABG, but could be reduced from 12.1% to 4.8%. Subjective and objective follow-up investigations were obtained in 77 of 84 survivors and demonstrate that successful reoperation is about 10% lower in patients with a malignant form of atherosclerosis (60%) than in patients who only suffer from occluded grafts or new proximal significant stenoses in previously unbypassed vessels (70%).
因顽固性心绞痛而进行主动脉冠状动脉再次手术的发生率不断上升，在4676例初次搭桥手术中平均占2%。移植血管闭塞、移植血管狭窄或疾病进展导致96例（84例男性，12例女性）接受二次手术的患者症状复发。并非所有闭塞或狭窄的搭桥血管都适合再次手术。医院死亡率（30天）高于初次冠状动脉旁路移植术（CABG）后，但可从12.1%降至4.8%。对84名幸存者中的77名进行了主观和客观的随访调查，结果表明，患有恶性动脉粥样硬化形式的患者（60%）再次手术成功的概率比仅患有移植血管闭塞或先前未搭桥血管出现新的近端严重狭窄的患者（70%）低约10%。
