Related Experiment Video
Updated: Jan 27, 2026
Surgical Swine Model of Chronic Cardiac Ischemia Treated by Off-Pump Coronary Artery Bypass Graft Surgery
Published on: March 27, 2018
Risk Factors and Outcomes in Redo Coronary Artery Bypass Grafting
Michele Gallo1, Jaimin R Trivedi1, Gretel Monreal1
1University of Louisville School of Medicine, Department of Cardiovascular and Thoracic Surgery, Louisville, KY, USA.
Insights
Reoperative coronary artery bypass grafting (redo-CABG) has comparable in-hospital mortality and long-term survival to first-time CABG. Prior percutaneous coronary intervention (PCI) and atherosclerotic risk factors predict the need for redo-CABG, which requires more blood products.
Area of Science:
- Cardiovascular Surgery
- Thoracic Surgery
- Interventional Cardiology
Background:
- Reoperative coronary artery bypass grafting (redo-CABG) has decreased, with increased use of percutaneous coronary intervention (PCI).
- Understanding risk factors and outcomes for redo-CABG is crucial for patient management.
- This study compares redo-CABG with first-time CABG.
Purpose of the Study:
- To evaluate risk factors for redo-CABG.
- To compare in-hospital mortality between first-time CABG and redo-CABG.
- To assess long-term survival after redo-CABG versus first-time CABG.
Main Methods:
- Retrospective study of 2,581 first-time CABG and 132 redo-CABG patients (2009-2015).
- Logistic regression identified risk factors for redo-CABG.
- Propensity matching compared in-hospital morbidity and long-term mortality.
Main Results:
- Prior PCI, dyslipidemia, diabetes, and hypertension were risk factors for redo-CABG.
- No significant baseline differences after propensity matching.
- Comparable in-hospital mortality (3.1% redo-CABG vs. 2.1% first-time CABG) and 5-year survival (85% redo-CABG vs. 93% first-time CABG).
- Redo-CABG required significantly more blood products.
Conclusions:
- Prior PCI and atherosclerotic disease risk factors predict redo-CABG.
- Redo-CABG necessitates increased blood product usage.
- In-hospital mortality and long-term survival are comparable between redo-CABG and first-time CABG after propensity matching.
Background:
Reoperative coronary artery bypass grafting (redo-CABG) has declined during the last decade, while use of percutaneous coronary intervention (PCI) has increased. The aim of this retrospective study was to evaluate risk factors, in-hospital mortality, and long-term survival between first-time CABG and redo-CABG.
Methods:
From January 2009 to December 2015, 2,581 patients underwent first-time CABG procedures while 132 underwent isolated redo-CABG. Logistic regression was used to identify risk factors predictive of redo-CABG and after propensity matching the in-hospital morbidity and long-term all-cause mortality were compared.
Results:
Risk factors for redo-CABG were prior PCI, dyslipidaemia, diabetes and hypertension. After propensity matching there were no significant differences between the redo-CABG (n = 126) and first-time CABG groups (n = 232) in baseline characteristics. The adjusted in-hospital mortality was 3.1% for redo-CABG and 2.1% for first-time CABG (p = 0.55). Redo-CABG required significantly more intraoperative red blood cells (p = 0.03), platelets (p < 0.001), cryoprecipitate (p < 0.007) and fresh frozen plasma (p < 0.001) than first-time CABG. There was no significant difference in reoperation for bleeding (p = 0.72), prolonged ventilation (p = 0.98), postoperative stroke (p = 0.92) or dialysis (p = 0.44). The survival at 1, 3 and 5 years for redo-CABG was 93.5%, 90%, and 85% respectively, and 95.5%, 94.5%, 93% for first-time CABG, respectively (p = 0.2).
Conclusions:
Prior PCI after first time CABG and the risk factors for atherosclerotic disease are predictive for redo-CABG. An increased use of blood products is required during redo-CABG. After propensity matching, in-hospital mortality and long-term survival for redo-CABG is comparable to first-time operation. Re-sternotomy does not impact the survival in redo-CABG.
Related Concept Videos
01:26Factors Affecting the Risk of Infection
The integrity and count of the white blood cells help the body resist pathogens and fight infection. When impaired, it reduces the body's resistance to pathogens. The acidic pH levels of the gastrointestinal, genitourinary tracts, and skin...
01:30Coronary Artery Disease I: Introduction
01:26Coronary Artery Disease II: Pathophysiology
01:27Coronary Artery Disease V: Interprofessional Care
01:26Coronary Artery Disease IV: Preventive Measures
01:30Coronary Artery Disease III: Clinical Manifestations