During the period from September 1989 through December 1992, 118 cases of coronary arterial bypass graft were performed at Department of Cardiothoracic Surgery, Asan Medical Center. Twentyone of these had history of recent or remote percutaneous
transluminal coronary angioplasty. They consisted of 13 males(age, 58.7*5.4 years) and 8 females(age, 63.6*2.8 years) with the mean age of 60.6. History of old myocardial infarction was noted in 24% (5/21) of the patients and congestive heart
failure in
2 cases. The angina by type of presentation is unstable in all of the patients. The patterns of involvement of coronary arterial disease were left main disease(1), single vessel disease(5), double vessels involvement(10), and triple vessels
involvement(5).
We performed 4 cases of single bypasses, 7 cases of double, 8 cases of triple, and 2 cases of quadruple bypasses. Total of 51 grafts(LIMA:12, RSVG: 39)were inserted in 21 cases with average of 2.4 grafts per patient. The methods of myocardial
protection
were cold blood cardioplegia(8 cases), intermittent aortic occlusion(11), and continuous coronary perfusion with local coronary sharing(2).
There were no operative or late death. The only cardiac complication was 1 case of low cardiac output required IABP. The other complications were 1case of sternal wound infection and 1 case of postoperative bleeding required reopration. And there
was no
case of perioperative myocardial infarction. Postoperatively, 3 cases of recurrent angina were detected at 5, 7, and 18 months after surgery. One of them was managed successfully with repeat PTCA(who was recurred 18 months postoperatively), and
the
other two with medication.
I conclude that we can approach the patients more aggressively with PTCA. Because of our acceptable operative risks. (Korean J Thoracic Cardiovas Surg 1994; 27:32-35)
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