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The Annals of Thoracic Surgery, Vol 38, 563-570, Copyright © 1984 by The Society of Thoracic Surgeons
ED Foster, LD Fisher, GC Kaiser and WO Myers
The National Heart, Lung, and Blood Institute's Coronary Artery Surgery
Study (CASS) registry population was reviewed to allow comparison of
operative mortality and morbidity rates for initial and repeat coronary
artery bypass grafting (CABG) procedures. Standardized data collection was
employed in CASS during patient entry (July 1, 1974, to May 31, 1979) and
follow-up (ended November 30, 1982). Initial CABG was performed on 9,369
patients. Mean follow-up was 60.5 months. Repeat CABG was required in 283
patients (3.0%). The mean interval between operations was 39.3 months.
Individuals needing reoperation tended to be young (p less than 0.0001) and
female (p less than 0.002) and to have less extensive coronary artery
disease (p less than or equal to 0.0001), less left ventricular impairment
(p less than 0.0001), less evidence of congestive heart failure (p =
0.006), and fewer coronary vessel systems bypassed at the first operation
(p less than 0.0001). Repeat CABG carried an increased risk of death
compared with initial CABG (5.3% versus 3.1%, respectively; p less than
0.05). However, the rates of perioperative myocardial infarction (6.4% for
repeat and 5.8% for initial CABG) and of all surgical complications
combined (30.6% versus 27.9%) were not significantly different from those
at initial CABG.
ARTICLES
Comparison of operative mortality and morbidity for initial and repeat coronary artery bypass grafting: The Coronary Artery Surgery Study (CASS) registry experience
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