title: Minimally invasive direct coronary artery bypass for redo patients.
abstract: BACKGROUND
  The minimally invasive direct coronary artery bypass (MIDCAB) procedure, using a small anterolateral thoracotomy without cardiopulmonary bypass, has been recommended for high-risk patients because it is less traumatic than conventional coronary artery bypass grafting. For redo patients who have patent grafts and pericardial adhesions, the MIDCAB may be preferable to the conventional operation because manipulation of the graft and dissection of adhesions may be minimized.
  
  
  METHODS
  Since November 1995, 120 patients underwent the MIDCAB procedure in our institution. Among these patients, there were 25 redo cases (20.8%). We reviewed these redo cases and studied their surgical results (mortality, morbidity, hospital stay, operation time, and postoperative inotropic support). To clarify the usefulness of this procedure, we compared the results of redo operations with those of the first-time operations.
  
  
  RESULTS
  For redo MIDCAB, there was one operative death (4%) because of intestinal infarction. The mean hospital stay was 4.3 days and the number of patients who needed postoperative positive inotropic agents was 3 (12%). There was no significant differences between redo and first-time operation patients in mortality, morbidity, hospital stay, operation time, and postoperative inotropic support.
  
  
  CONCLUSIONS
  Results of the MIDCAB procedure for redo patients were comparable to those for primary MIDCAB operations.
authors.affiliation: Department of Cardiac Surgery, The Christ and Jewish Hospital, University of Cincinnati, Ohio, USA.
authors.forename: K
authors.initials: K
authors.lastname: Miyaji
authors.forename: R K
authors.initials: RK
authors.lastname: Wolf
authors.forename: J B
authors.initials: JB
authors.lastname: Flege
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001026:Coronary Artery Bypass / Q000379:methods*; D003327:Coronary Disease / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D012086:Reoperation; D012189:Retrospective Studies; D016896:Treatment Outcome