Trends of re-operative coronary artery bypass grafting: A two-decade experience

The prevalence of redo coronary artery bypass grafting has markedly changed over the last two decades. We aim to assess the trends of redo coronary artery bypass grafting and clinical outcomes of redo coronary artery bypass grafting over two different periods.

This is a retrospective, metachronous, observational study of patients who underwent redo coronary artery bypass grafting between January 1998 through December 2004 and January 2005 through September 2021 who were categorized into group 1 and group 2, respectively. The trends in the prevalence of redo coronary artery bypass grafting, and 30-day outcomes were analyzed.

A total of 261 patients underwent a redo coronary artery bypass grafting. Group 1 and group 2 included 114 and 147 patients, respectively. 62.59% of group 2 patients underwent off-pump coronary artery bypass grafting compared to 6.14% in group 1 (p < 0.01). The patients undergoing redo coronary artery bypass grafting in group 2 were significantly older (60.65 ± 7.78 years vs. 50.99 ± 7.66 years, p < 0.001) and were more likely to be hypertensive (49.66% vs. 29.82%, p < 0.001). There was no significant difference in the proportion of diabetes (p = 0.82), smoking (p = 0.24), dyslipidemia (p = 0.64), and preoperative myocardial infarction (p = 0.14). The proportion of patients who presented post-PCI was significantly higher in group 2 (27.89% vs. 10.53%, p < 0.001). There was also a shift in the usage of grafts from the left internal thoracic artery to the saphenous vein graft (p < 0.001).

The annual rate of redo coronary artery bypass grafting was declining but has now reached a plateau. The current outcomes of patients undergoing redo coronary artery bypass grafting are comparable to that of the earlier times despite a higher co-morbidity burden in patients of recent times.