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Updated: Jul 27, 2026
Surgical Swine Model of Chronic Cardiac Ischemia Treated by Off-Pump Coronary Artery Bypass Graft Surgery
Published on: March 27, 2018
Late outcome of reoperative coronary revascularization on the beating heart
S C Stamou1, A J Pfister, M K Dullum
1Section of Cardiac Surgery, Department of Surgery, Washington Hospital Center, Med-Star Research Institute, Washington, DC 20010, USA. sxss3@mhg.edu
Insights
Off-pump redo coronary artery bypass grafting (CABG) offers a safe approach for patients needing repeat surgery. This method demonstrates a low mortality rate and reduced need for reintervention, improving patient outcomes.
Area of Science:
- Cardiovascular Surgery
- Cardiac Surgery Outcomes
- Minimally Invasive Cardiac Surgery
Background:
- Reoperative coronary artery bypass grafting (CABG) carries higher risks than primary CABG.
- Off-pump techniques may offer advantages for redo CABG patients.
- This study evaluates the clinical outcomes of off-pump redo CABG.
Purpose of the Study:
- To assess the early and long-term clinical outcomes of patients undergoing off-pump redo CABG.
- To determine the safety and efficacy of this surgical approach in a redo setting.
Main Methods:
- A retrospective analysis of 138 patients who underwent off-pump redo CABG between July 1985 and January 1999.
- Surgical approaches included median sternotomy and minimally invasive direct coronary artery bypass (MIDCAB) via anterior or lateral incisions.
- Patient demographics and procedural details were recorded.
Main Results:
- Operative mortality was 2% (3 out of 138 patients).
- Target lesion re-intervention rate was 6% (9 out of 138 patients).
- Actuarial survival at a mean follow-up of 2.5 years was 83%, with event-free survival at 67%.
Conclusions:
- Off-pump redo CABG is a safe procedure with acceptable mortality rates.
- The rate of target lesion revascularization is low, indicating good long-term graft patency and clinical benefit.
Background:
Reoperative (redo) coronary artery bypass grafting (CABG) is associated with a higher morbidity and mortality than first-time CABG. An off-cardiopulmonary bypass (off-pump) approach to redo CABG, however, may potentially benefit redo patients. The aim of the present report is to describe the early and long-term clinical outcome of patients who underwent off-pump redo CABG between July 1985 and January 1999 in our institution.
Methods:
Redo patients (n = 138) represented 13% of patients who had off-pump CABG during the period of study (n = 1072). Mean patient age was 63 +/- 12 years, and 67% were men. Surgical approaches included median sternotomy (n = 93, 67%), anterior (n = 20, 15%) and lateral (n = 25, 18%) minimally invasive direct coronary artery bypass (MIDCAB).
Results:
Operative mortality was 2% (n = 3). Target lesion re-intervention was 6% (n = 9) Actuarial survival at a mean period of follow-up of 2.5 +/- 1 year (range: 1 month to 11 years) was 83%. Event-free survival (freedom from death, myocardial infarction, and repeat intervention) was 67%. Overall cardiac-related mortality was 10% (n = 14).
Conclusion:
Off-pump redo CABG can be safely performed with a relatively low mortality rate and a low rate of target lesion revascularization.
