Results of reoperation for unsuccessful coronary artery bypass surgery.

Twenty-one reoperations for relief of angina have been performed at Stanford Medical Center in patients who had had previously unsuccessful direct coronary artery surgery. Complete releif of angina was obtained in seven (33%), improvement of angina in six (29%), and no change in angina in eight (38%) after these operations. Reoperation was least successful in relieving angina when performed in patients with graft occlusion and most successful when performed in patients with new critical lesions or with previously unbypassed critical lesions (P less than 0.02). Reoperation was of greater benefit in patients with unstable angina than in those with stable angina (P less than 0.05). Four of the seven patients having no angina after reoperation sustained perioperative infarctions. Reoperation does not provide the same rate of angina relief as first operations; however, certain subgroups of patients may exhibit more favorable results.