Off-pump redo coronary artery bypass grafting via left thoracotomy.
OBJECTIVE
We evaluated the usefulness of off-pump coronary artery bypass grafting (CABG) via left thoracotomy (LT) in redo coronary revascularization.


METHODS
Over the past 23 years, 21 patients (2.3%) underwent redo coronary revascularization in our hospital. The period between the first and the redo surgeries was 9.1+/-4.4 years. They were divided into two groups according to the method of surgical approach in the redo CABG: re-median sternotomy group (RMS group, n=12) and LT group (n=9).


RESULTS
In the RMS group, five of 12 patients suffered prolonged postoperative respiratory failure with ventilatory support, and the RMS patients stayed in the hospital for a significantly longer period of time than the LT patients. Four patients (19.0%, 4/21), who were all in the RMS group, died during the hospitalization. In the LT group, there were no hospital deaths and no cases of respiratory failure.


CONCLUSIONS
Redo CABG via LT provided acceptable and satisfactory surgical results. As it is expected that the number of emergency reoperative surgical cases will increase, the LT approach may be useful for rapid exposure of the target coronary artery without causing significant myocardial damage.
Kuniyoshi
Yukio
Y
Second Department of Surgery, School of Medicine, Faculty of Medicine, University of Ryukyus, Okinawa, Japan.
Yamashiro
Satoshi
S
Miyagi
Kazufumi
K
Uezu
Toru
T
Arakaki
Katsuya
K
Koja
Kageharu
K
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D001026:Coronary Artery Bypass; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012086:Reoperation; D013249:Sternum / Q000601:surgery; D016019:Survival Analysis; D013908:Thoracotomy / Q000379:methods*; D016896:Treatment Outcome