Late results of 200 repeat coronary artery bypass operations.
 To determine the clinical outcome and the long-term results of a second coronary artery bypass operation, we studied preoperative clinical status and catheterization data in 200 consecutive patients over a 9-year period (1979 to 1987) (mean follow up time 34 months, maximum 120).
 The study group included 169 men and 31 women (mean age 58.4 years [7% greater than 70 years]).
 Sixty-four percent of patients had severe angina (New York Heart Association class IV), 70% had 3-vessel coronary artery disease and 21% had poor left ventricular function.
 Reoperation was performed after a mean interval of 58 months after the first procedure.
 A mean of 3.3 distal anastomoses was placed.
 The operative mortality rate (30 days) was 7.5%, with additional cardiac morbidity (myocardial infarction, heart failure) in 11.5% of patients.
 Multivariate analysis showed an increased risk in women (risk ratio 3.6) and in patients with poor left ventricular function (risk ratio 3.1).
 The cumulative 5-year survival rate was estimated at 84%, with a rate of 77% for patients with poor left ventricular function (difference not significant).
 The probability of remaining free of a cardiac-related event (myocardial infarction, angioplasty, third operation, cardiac death) was 64% for 5 years.
 At the end of follow-up, 79% of the surviving patients were in New York Heart Association class I or II and nearly 50% of patients in the fifth year after the reoperation had good functional status.
 It is concluded that a reoperation is effective but carries an increased, immediate, operative risk.
