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Redo coronary artery bypass grafting: early and mid-term results
Hitoshi Hirose1, Atsushi Amano, Akihito Takahashi
1Department of Cardiovascular Surgery, Shin-Tokyo Hospital, Chiba, Japan. genex@nifty.com
Insights
Redo coronary artery bypass grafting (CABG) offers acceptable risks and satisfactory long-term outcomes. This study evaluated early and remote results of 71 patients undergoing repeat CABG surgery.
Area of Science:
- Cardiovascular Surgery
- Cardiac Surgery Outcomes
- Graft Patency
Background:
- Redo coronary artery bypass grafting (CABG) procedures are increasingly common.
- Evaluating the outcomes of repeat CABG is crucial for patient management.
Purpose of the Study:
- To assess the early and long-term results of isolated redo-CABG.
- To determine the safety and efficacy of repeat cardiac revascularization.
Main Methods:
- Prospective data collection from 71 patients undergoing isolated redo-CABG between 1994 and 2002.
- Analysis of perioperative complications, early graft patency via angiography, and long-term clinical follow-up.
Main Results:
- The hospital mortality rate was 2.8% with a 26.8% major complication rate.
- The 5-year event-free survival rate was 76.4%, and the survival rate was 83.9%.
- Stenosis-free graft patency at early follow-up was 93.9%.
Conclusions:
- Redo-CABG can be performed with acceptable risks in experienced centers.
- The long-term results of redo-CABG are satisfactory, supporting its role in selected patients.
Objectives:
Redo coronary artery bypass grafting (CABG) has been gradually increasing in Japan. We prospectively collected redo-CABG data and evaluated these the early and remote results.
Methods:
Between 01/01/1994 and 06/30/2002, a total of 71 patients underwent isolated redo-CABG in our hospital group. The interval between operations was 7.8 +/- 6.1 years. Previous surgery was CABG in all patients. Perioperative, early angiographic, and follow-up results were analyzed.
Results:
The mean number of grafts was 2.9 +/- 1.2. There were 4 incidences of injury to the heart or graft during sternal re-entry or during dissection of the heart. There was 1 hospital death (2.8%) and 19 major complications (26.8%), including 7 patients (9.9%) with postoperative congestive heart failure and 2 (2.8%) with postoperative myocardial infarction. Postoperative angiography was obtained in 47 patients and their overall stenosis free patency rate was 93.9%. Follow-up was completed for all hospital survivors with a mean follow-up of 3.9 +/- 2.2 years. The event-free and survival rates at 5 years were 76.4% and 83.9%, respectively.
Conclusion:
In our limited experience, redo-CABG was performed with acceptable risks and its long-term results were satisfactory.
