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Third-time coronary artery bypass grafting
L Noyez1, I M Touma, S H Skotnicki
1Department of Thoracic and Cardiac Surgery, University Hospital Nijmegen, The Netherlands. l.noyez@thchir.azn.nl
Background:
In this study we analyze the short- and long-term results, and the clinical, functional, and subjective status of patients after a second coronary reoperation (RE-RE-CABG).
Methods:
The perioperative data of 33 consecutive patients undergoing RE-RE-CABG (1987 to 1998) were studied. Follow-up information was obtained from our follow-up databank. A cross-sectional follow-up was conducted, with additional functional evaluation by the Duke Activity Status Index (DASI), and patients' evaluations of their life situation were registered.
Results:
Perioperative mortality was 2 of 33 patients (6%). During the follow-up (mean 51.6 months) 5 patients died. The 26 survivors showed a significant decrease in New York Heart Association class from 3.6+/-0.4 preoperatively versus 2.2+/-0.6 postoperatively. The mean Duke Activity Status Index score was 29.30+/-16.34 (range 7.22 to 48.9). In all, 18 of 26 patients (70%) were declared to have benefitted from the RE-RECABG.
Conclusions:
The significant improve in New York Heart Association class and good postoperative functional capacity, justified the RE-RE-CABG. However, patients must be informed about the limitations of this procedure.