Evaluations of factors affecting the outcome of redo coronary bypass surgery and long term results: A retrospective observational study
Keywords:Coronary artery bypass surgery, Vascular graft occlusion, Redo surgery
Aim: Advanced atherosclerosis of coronary arteries, existence of patent arterial grafts, redo sternotomy, shortage of available vascular conduits, difficulty of exploration of the coronary vessels are the factors that render the coronary reoperations challenging and they may be responsible of higher mortality and morbidity rates of reoperations. The aim of this study is to evaluate the factors that affect the progression of atherosclerotic coronary artery disease in the post-operative period of coronary artery bypass surgery which results in a redo operation.
Methods: A number of 115 patients who underwent coronary bypass re-operations between January 1997 and August 2007 were included. Patients were divided into two groups as follows: Group 1 was the risk factor positive group, Group 2 was the risk factor negative group. The time interval between the initial operative procedure and the redo operation was calculated and the effect of risk factors upon this time interval and the mortality rates were evaluated.
Results: The time interval between the first operative procedure and the reoperation was 77.31 months in Group 1 and 93.88 months in Group 2. Smoking had a more negative effect on the reoperation rate compared to the other risk factors (p=0.025). Mortality rate was higher in the risk factor positive group (p=0.027). Preoperative EF had a significant effect on the mortality rates (p=0.018).
Conclusion: The presence of any risk factor for CAD increases the chance of having a reoperation. Off-pump surgery technique should be chosen in appropriate cases to lower the mortality risk of redo CABG operations and choosing the combined cardioplegia administration in on-pump redo coronary bypass operations would lower the mortality rate as well.
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