Late outcome of reoperative coronary revascularization on the beating heart.
BACKGROUND
Reoperative (redo) coronary artery bypass grafting (CABG) is associated with a higher morbidity and mortality than first-time CABG. An off-cardiopulmonary bypass (off-pump) approach to redo CABG, however, may potentially benefit redo patients. The aim of the present report is to describe the early and long-term clinical outcome of patients who underwent off-pump redo CABG between July 1985 and January 1999 in our institution.


METHODS
Redo patients (n = 138) represented 13% of patients who had off-pump CABG during the period of study (n = 1072). Mean patient age was 63 +/- 12 years, and 67% were men. Surgical approaches included median sternotomy (n = 93, 67%), anterior (n = 20, 15%) and lateral (n = 25, 18%) minimally invasive direct coronary artery bypass (MIDCAB).


RESULTS
Operative mortality was 2% (n = 3). Target lesion re-intervention was 6% (n = 9) Actuarial survival at a mean period of follow-up of 2.5 +/- 1 year (range: 1 month to 11 years) was 83%. Event-free survival (freedom from death, myocardial infarction, and repeat intervention) was 67%. Overall cardiac-related mortality was 10% (n = 14).


CONCLUSIONS
Off-pump redo CABG can be safely performed with a relatively low mortality rate and a low rate of target lesion revascularization.
Stamou
S C
SC
Section of Cardiac Surgery, Department of Surgery, Washington Hospital Center, Med-Star Research Institute, Washington, DC 20010, USA. sxss3@mhg.edu
Pfister
A J
AJ
Dullum
M K
MK
Boyce
S W
SW
Bafi
A S
AS
Lomax
T
T
Garcia
J M
JM
Corso
P J
PJ
D000368:Aged; D000369:Aged, 80 and over; D001026:Coronary Artery Bypass / Q000379:methods*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012086:Reoperation; D016019:Survival Analysis; D016896:Treatment Outcome