Results of reoperation for recurrent angina pectoris.

Although a coronary bypass operation improves the quality of life and possibly prolongs it, a small percentage of patients do not have satisfactory results and require reoperation. From July, 1970, to March 1975, 358 patients underwent coronary bypass for chronic disabling or preinfarction angina. Angina requiring operation recurred in 24 men and 2 women. Hyperlipoproteinemia was present in 19 of the 26 (73%), and 3 patients had early-onset diabetes mellitus. Only 2 of 14 patients with progression of arteriosclerosis were helped by a second operation. Of 7 patients with occluded grafts, local disease, and no progression, 5 were helped by reoperation. Patients with occluded coronary bypass grafts without progression of arteriosclerosis benefit substantially from a second revascularization procedure. Aguarded prognosis must be held, however, for those with progression of arteriosclerosis with hyperlipoproteinemia or juvenile-onset diabetes who undergo reoperation. Patients with initially diffuse disease and graft occlusion also seem to benefit less from a second operation.