Redo coronary artery surgery; early and intermediate outcomes from a tertiary care hospital in a developing country
Syed Shahabuddin1, Junaid Alam Ansari, Fahad Jawaid Siddiqui
1Cardiothoracic Surgery Section, Department of Surgery, The Aga Khan University, Karachi, Pakistan.
Objective:
To evaluate outcomes of re-operative coronary artery surgery in a tertiary care hospital in a developing country.
Method:
Preoperative, intra-operative and postoperative variables were analyzed in 82 consecutive patients who underwent re-operative coronary surgery on cardiopulmonary bypass.
Results:
The mean age was 63.3 +/- 7.7 years, 91.2% were male and 9.8% female. Coronary artery disease risk factors were present in more than 50% of the patients. History of preoperative myocardial infarction was positive in 56% patients. There was strong clinical and angiographic indication for surgery with unstable angina in 50% patients and > 80% had multivessel disease. Only 5% patients were in functional class I. The risk stratification showed a mean Euro score of 8. The IABP was used in 20% patients. A mean of 3.1 grafts per patient were applied. The median cardiopulmonary bypass (CPB) and aortic cross clamp time was 144 minutes respectively. Postoperative mortality was 7.3%. Short-term follow up revealed 74% of the patients in NYHA functional class I.
Conclusion:
Reoperative coronary artery bypass grafting is challenging but with expertise, team effort can be performed with good functional outcome.
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