Related Experiment Videos
Long-term follow-up after coronary artery bypass grafting reoperation
I Shapira1, A Isakov, I Heller
1Post-Cardiac Surgery Follow-up Clinic, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Israel. shapiraiz@tasmc.health.gov.il
Insights
Second coronary artery bypass grafting (CABG) reoperation shows good long-term survival and cardiac event-free survival rates. However, advanced age, hypertension, and low left ventricular ejection fraction increase surgical risk.
Area of Science:
- Cardiovascular Surgery
- Cardiac Surgery Outcomes
- Reoperative Coronary Artery Bypass Grafting
Background:
- Coronary artery bypass grafting (CABG) reoperation is increasingly common.
- Assessing outcomes of repeat CABG is crucial for patient management.
Purpose of the Study:
- To evaluate the clinical outcomes and long-term results of a second CABG.
- To identify factors influencing survival after CABG reoperation.
Main Methods:
- Retrospective analysis of 498 patients undergoing CABG reoperation from 1978-1989.
- Prospective follow-up for up to 15 years, assessing perioperative mortality, morbidity, and survival rates.
Main Results:
- Perioperative mortality was 3%.
- 15-year survival and cardiac event-free survival rates were 63.4% and 67.8%, respectively.
- Advanced age, hypertension, and low left ventricular ejection fraction (LVEF) were significant risk factors for mortality.
Conclusions:
- CABG reoperation offers good long-term survival and cardiac event-free survival.
- The procedure is generally safe, but patient-specific factors like age, hypertension, and LVEF impact risk.
Background:
Coronary artery bypass grafting (CABG) reoperation is being performed with increasing frequency.
Objective:
To determine the clinical outcome and the long-term results of a second CABG.
Setting:
An 1100-bed urban university-affiliated hospital.
Design:
Retrieval of data on selected parameters from medical records before surgery and prospective follow-up afterwards.
Patients And Methods:
We studied the outcomes of 498 consecutive patients who underwent CABG reoperation in our institution from January 1978 to December 1989 and who were followed postoperatively. Their perioperative mortality, morbidity, and long-term follow-up results were re-evaluated. The end points of the study were December 1997, 15 years of follow-up, or the patient's death.
Results:
The perioperative mortality rate was 3%. The cumulative survival rates were 90.1%, 74%, and 63.4% at the 5-year, 10-year, and 15-year follow-ups, respectively. The cardiac event-free survival rates were 91.5%, 83.4%, and 67.8% at the 5-year, 10-year, and 15-year follow-ups, respectively. The risk factors adversely affecting long-term survival were advanced age, hypertension, and a low left ventricular ejection fraction (LVEF).
Conclusions:
The long-term results of cumulative survival and cardiac event-free survival in patients who underwent CABG reoperation are good. Although this reoperation is safe overall, advanced age, hypertension, and a decreased LVEF significantly increase the surgical risk.