Coronary bypass surgery after renal transplantation.

Aortocoronary bypass surgery was performed in three patients with incapacitating angina pectoris who had previously had successful renal transplantation. All patients had initial symptomatic improvement. Although two have mild angina pectoris, there is objective improvement in their exercise tolerance and in ischemic ST-T changes on treadmill exercise testing. One patient, who also had resection of a left ventricular aneurysm, remains free of angina but is symptomatic from congestive heart failure. There were no postoperative complications. To our knowledge, these three cases are the first in which aortocoronary bypass surgery has been performed successfully in patients who have had renal transplantation. Anticipated problems with infection in view of the immunosuppressive therapy and renal problems postoperatively were not encountered.