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Multiple reoperative coronary artery bypass grafting
K D Accola1, J M Craver, W S Weintraub
1Joseph B. Whitehead Department of Surgery, Emory University School of Medicine, Atlanta, Georgia.
The Annals of Thoracic Surgery
|October 1, 1991
Summary
Third or fourth coronary artery bypass grafting (CABG) is uncommon but feasible. Despite increased risks, this reoperative CABG demonstrates acceptable in-hospital and long-term survival rates for carefully selected patients.
Area of Science:
- Cardiovascular Surgery
- Cardiac Surgery
- Thoracic Surgery
Background:
- Reoperative coronary artery bypass grafting (CABG) is increasingly common.
- A subset of patients require a third or fourth CABG operation.
Purpose of the Study:
- To evaluate the safety and efficacy of third or fourth reoperative CABG.
- To assess in-hospital and long-term outcomes of these complex procedures.
Main Methods:
- Retrospective review of 53 patients undergoing third or fourth CABG between 1980 and 1990.
- Analysis of perioperative complications, mortality, and long-term survival.
Main Results:
- No intraoperative deaths; 4 in-hospital deaths.
- Perioperative complications included myocardial infarction (6), dysrhythmias (13), stroke (2), and wound infection (5).
- 3-year survival was 85%, with 70% myocardial infarction-free survival.
Conclusions:
- Third or fourth reoperative CABG carries increased risks.
- Acceptable in-hospital and long-term outcomes support its use in selected patients.