[ outcomes of redo-coronary artery bypass grafting]

ABSTRACT

Application of off-pump technique for reoperative coronary artery bypass grafting [Redo CABG] has been limited by technical difficulties, potentiation for embolism of athermanous debris from the involved grafts, resulting in myocardial infarction, and rapid hemodynamic deterioration. In this descriptive study from 2002, at Cardiac surgery Department of Emam Reza Hospital, a total of 77 consecutive patients underwent redo CABG [64 ONCAB and 13 OPCAB] The outcomes of off-pump [OPCAB] and on-pump [ONCAB] redo CABG were compared. Surgical technique in 2 patients [%11] was converted from OPCAB to ONCAB due to hemodynamic instability, severe adhesion or graft injury; and in one patient [%7] the conversion from ONCAB to OPCAB was for severe aorta calcification. Propensity matched comparison of the outcome of OPCAB with ONCAB for redo CABG showed that OPCAB was associated with significant reduction in postoperative complications, volume of blood transfusion and hospitalization length. OPCAB can be safely and effectively applied for reoperative CABG, in selected cases