[Early results of coronary artery bypass reoperations in own experience].
Coronary Artery Bypass Grafting (CABG) is widely accepted as an effective and durable method of treatment of Coronary Artery Disease. In some patients however, recurrent angina and the necessity of reoperation (RE-CABG) occurs.


OBJECTIVE
The aim of the study is the estimation of the results of RE-CABG in own material.


METHODS
In years 1995-2002 CABG operations were performed in 3452 patients (CABG group) and RE-CABG in 37 pts (1.07%) (RE-CABG group). Patients were considered for operation on condition of the presence of symptomatic CAD confirmed by coronarography in standard projections. Operations were performed using Cardiopulmonary Bypass.


RESULTS
The CABG group consisted of 3452 pts in mean age 57.9 years, including 2693 men (78%) and 759 (22%) women. The RE-CABG group was composed of 37 pts in mean age 60.7 years, comprising 22 (59.5%) men and 15 (40.5%) women. The percentage of women in CABG group was significantly higher than in CABG group. The mean age in RE-CABG group was insignificantly higher than in CABG group. In the CABG group 3.1 anastomosis/pt were performed, including anastomosis IMA to LAD in 2779 pts (80.5%). From this group only in 2 pts (0.07%) coronary reoperations were performed. In the remaining 673 pts from CABG group during the first operation, only saphenous vein graft were performed and in 35 (5.2%) coronary reoperation was necessary. This difference is statistically significant. In-hospital mortality in CABG group was 5%, the IABP was used in 7.8% of pts. Mortality in the RE-CABG group reached 8.1% (3/37), the IABP was used in 16.2% (6/37).


CONCLUSIONS
1. The use of arterial grafts during the first coronary operation decreases the reoperation rate. 2. RE-CABG are performed in the older patient rather than CABG. 3. RE-CABG are performed more frequently in women than in men as compared to CABG. 4. RE-CABG are burdened with twice as high mortality rate and the necessity of use of IABP than CABG.
Hirnle
Tomasz
T
Klinika Chirurgii Serca Akademii Medycznej, Wrocław. hirnlet@wp.pl
Pelczar
Marek
M
Kustrzycki
Wojciech
W
Stachurski
Andrzej
A
Hirnle
Grzegorz
G
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001026:Coronary Artery Bypass; D003324:Coronary Artery Disease / Q000601:surgery*; D005260:Female; D006083:Graft Occlusion, Vascular; D006801:Humans; D008297:Male; D008875:Middle Aged; D012086:Reoperation; D012189:Retrospective Studies; D016896:Treatment Outcome