Clinical outcomes after redo coronary artery bypass grafting / 中华胸心血管外科杂志

ABSTRACT

Objective Evaluate the clinical outcomes of redo coronary revascularization performed with CABG techniques. Methods During the past 10 years, 51 patients (2.5% in the patients who underwent CABG and OPCABG) received redo coronary revascularization in our hospital. The period between the first and the redo surgeries was ( 15.1±5.8)years. Two different procedures were performed with or without cardiopulmonary bypass for the redo CABG off-pump procedure (OPCABG) in 10 patients and on-pump procedure (CABG) in 41 patients. Two types of surgical approaches were used me-dian sternotomy in 43 patients and left thoracotomy in 8 patients. Results Respiratory failure requiring mechanical ventilation occurred in 3 of the 51 patients after the operation, as compared with none in the patients who underwent OPCABG. The mean duration treated in the ICU was (2.2±0.7 ) days and that of hospital admission was( 9.2±2.4) days. Two patients (3.9%)died in hospital, one ease was in the off-pump group and the other was in the on-pump group. The causes of death were thought to be acute myocardial infarction with low output syndrome in 1 case and severe respiratory failure in the other. Complications occurred in 11 patients, including re-thoracotomy for hemostasis in 1 patient, respiratory failure in 3 patients and other complications 7. Postoperative EF was 0.60±0. 06. Complete revascularization was achieved in 44 patients, 6 patients in the offpump group and 38 patients in the on-pump group. Partial revascularization was observed in the additional 7 patients. Conclusion Redo CABG performed with or without cardiopuimonary bypass may provide favorable effects with acceptable safety profile and complete revascularization is achievable.