title: Posterior thoracotomy for reoperative coronary artery bypass grafting without cardiopulmonary bypass: perioperative results.
abstract: BACKGROUND
  This retrospective study evaluates morbidity and mortality of reoperative coronary artery bypass grafting (CABG) without cardiopulmonary bypass (CPB) using a posterior thoracotomy to revascularize the lateral aspect of the heart.
  
  
  METHODS
  From January 1995 to July 1999, reoperative CABG without CPB was performed on 67 selected patients using a left posterior thoracotomy approach. Preoperative risk factors, postoperative mortality, and major complications were derived from the New York State database.
  
  
  RESULTS
  All patients were operated on without CPB. A total of 1.3 grafts per patient were performed. Freedom from major complications was 95.5%. There were no postoperative cerebro-vascular accidents (CVA) or new neurological deficits. Two patients (3%) had a perioperative acute myocardial infarction. The actual mortality rate was 4.5% (3/67), the expected mortality was 5.1% and the calculated risk adjusted mortality was 2.1%.
  
  
  CONCLUSIONS
  Reoperative CABG without CPB to revascularize selected coronary artery targets can be safely performed using a posterior thoracotomy approach.
authors.affiliation: Division of Cardiothoracic Surgery and the Center for Minimally Invasive Cardiac Surgery, Kaleida Health-Buffalo General Hospital Site and SUNY at Buffalo, Buffalo, New York 14203, USA.
authors.forename: G
authors.initials: G
authors.lastname: D'Ancona
authors.forename: H
authors.initials: H
authors.lastname: Karamanoukian
authors.forename: T
authors.initials: T
authors.lastname: Lajos
authors.forename: M
authors.initials: M
authors.lastname: Ricci
authors.forename: J
authors.initials: J
authors.lastname: Bergsland
authors.forename: T
authors.initials: T
authors.lastname: Salerno
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002315:Cardiopulmonary Bypass; D001026:Coronary Artery Bypass / Q000379:methods* / Q000401:mortality; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009518:New York / Q000453:epidemiology; D011183:Postoperative Complications / Q000453:epidemiology; D012086:Reoperation; D012189:Retrospective Studies; D015996:Survival Rate; D013908:Thoracotomy / Q000379:methods* / Q000401:mortality; D016896:Treatment Outcome