Changing profile of patients undergoing redo-coronary artery surgery.
OBJECTIVE
To outline the changes of the patient population undergoing redo-coronary artery bypass surgery (RECABG).


METHODS
Preoperative data of 582 first RECABGs, January 1987-June 2000 were analyzed. Group A: 1987-1991 (n=193); group B: 1992-1995 (n=201); and group C: 1996-June 2000 (n=188).


RESULTS
These 582 RECABGs represent about 8.5% of the performed bypass surgeries during this period. Mean age (P=<0.001), percentage of patients with kidney disease (P=0.001), a preoperative PTCA (P<0.001) increased. Significant more elective operations (P<0.001) and lesser urgent operations (P=0.001) were performed in group C. There is a significant different distribution of vessel disease over the three periods (P=0.04). Significant more patients had a patent IMA graft (P<0.001). The angina-free period after CABG (P<0.001), the time period between both operations (P<0.001) and the period between the new onset of angina and the RECABG (P=0.012) increased significantly. Despite the importance of progression of atherosclerosis of any sort decrease significantly (P<0.001) over the whole study, there is a significant increase of patients reoperated for isolated progression of the disease in the native coronary arteries (P<0.001) in group C. The impact of late GF was not different for the total group (P=0.82), however, the percentage of RECABGs for isolated late GF increased significantly between group A and B (P<0.001) but there was a decrease from B to C, however, not significant (P=0.067).


CONCLUSIONS
During the past few years there is a trend in RECABG of older patients, with more coexisting diseases. There are an increasing number of patients with patent arterial grafts, an increase of the event-free period after the CABG, the period between the CABG and RECABG and of the time period between the onset of new angina and the RECABG. Although the impact of atherosclerosis, as angiographic indication, decreased over the total group, there is the significant increase of the percentage of patients reoperated because of isolated progression of atherosclerosis in the native coronary arteries.
van Eck
Frans M
FM
Heart Center, Department of Thoracic and Cardiac Surgery-414, University Medical Center St. Radboud Nijmegen, 6500 HB Nijmegen, The Netherlands.
Noyez
Luc
L
Verheugt
Freek W A
FW
Brouwer
Rene M H J
RM
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D001026:Coronary Artery Bypass / Q000009:adverse effects* / Q000379:methods / Q000401:mortality; D003327:Coronary Disease / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D005260:Female; D006084:Graft Rejection / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D011336:Probability; D011379:Prognosis; D012042:Registries; D012086:Reoperation / Q000639:trends*; D018570:Risk Assessment; D015996:Survival Rate; D016896:Treatment Outcome