| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
Ann Thorac Surg 2000;70:1026-1029
© 2000 The Society of Thoracic Surgeons
a Escorts Heart Institute and Research Centre, New Delhi, India
Address reprint requests to Dr Mishra, Escorts Heart Institute and Research Centre, Okhla Rd, New Delhi 110025, India
e-mail: ehirc{at}vsnl.com
Presented at the Sixth Annual Cardiothoracic Techniques and Technologies Meeting 2000, Ft Lauderdale, FL, Jan 27–29, 2000.
Background. Conventional redo coronary artery bypass grafting is associated with significant morbidity. The danger of reoperation is mainly in reopening the sternum and in the manipulation of the heart and the old grafts. Therefore, off-pump redo coronary artery bypass grafting with a patient-specific approach in selected cases seems an ideal technique.
Methods. Between October 1995 to September 1999, 50 patients with mean age of 61.8 ± 8 years underwent reoperative coronary artery bypass grafting without cardiopulmonary bypass. Isolated left internal mammary artery (LIMA) to left anterior descending artery (LAD) anastomosis was carried out in 25 cases through left anterior minithoracotomy. In 1 patient LIMA was grafted on a previous vein graft to LAD, which was critically stenosed proximally but distal anastomosis was patent. In another case LIMA was grafted to Ramus intermedius branch. Midsternotomy approach was used to carry out LAD and right coronary artery grafting in 21 cases. In 2 patients a posterolateral thoracotomy approach was used to bypass obtuse marginal branches without cardiopulmonary bypass; in these cases proximal anastomosis was performed on the descending aorta.
Results. Mortality rate was 4% (2 deaths). Two patients sustained perioperative myocardial infarction. No patient was reexplored for hemorrhage and 38 patients did not require homologous blood transfusion. Sixteen patients underwent check angiogram and all of them were found to have patent redo grafts. Cardiac recovery room stay was 22 ± 7 hours and hospital stay 5 ± 2 days.
Conclusions. In selected patients, reoperative coronary artery bypass grafting can be performed without cardiopulmonary bypass with a low perioperative morbidity and mortality and satisfactory graft patency.
This article has been cited by other articles:
|
|
 |
|
  C.-H. Yap, L. Sposato, E. Akowuah, S. Theodore, D. T. Dinh, G. C. Shardey, P. D. Skillington, J. Tatoulis, M. Yii, J. A. Smith, et al. Contemporary results show repeat coronary artery bypass grafting remains a risk factor for operative mortality. Ann. Thorac. Surg., May 1, 2009; 87(5): 1386 - 1391. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 H. A. Vohra, T. Bahrami, S. Farid, A. Mafi, G. Dreyfus, M. Amrani, and J. A.R. Gaer Propensity score analysis of early and late outcome after redo off-pump and on-pump coronary artery bypass grafting Eur. J. Cardiothorac. Surg., February 1, 2008; 33(2): 209 - 214. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T. M. Dewey and M. J. Mack Myocardial Revascularization without Cardiopulmonary Bypass Card. Surg. Adult, January 1, 2008; 3(2008): 633 - 654. [Full Text]
|
|
|
|
|
|
S. Jacobs, D. Holzhey, T. Walther, V. Falk, and F. W. Mohr Redo Minimally Invasive Direct Coronary Artery Bypass Grafting Ann. Thorac. Surg., October 1, 2005; 80(4): 1336 - 1339. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. Shennib and O. Benhameid Sequential Subxyphoid and Thoracotomy Incisions With Graft Pull Through for Targeted Redo Multivessel Surgical Revascularization Ann. Thorac. Surg., July 1, 2005; 80(1): 350 - 352. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 H. Hirose, A. Amano, L. Ruzheng, and Z. Xiang Routine Reoperative Off-Pump Coronary Artery Bypass Grafting Via Midline Sternotomy: Is It Feasible? Angiology, May 1, 2005; 56(3): 243 - 248. [Abstract] [PDF]
|
|
|
|
|
|
M. Di Mauro, A. L. Iaco, M. Contini, G. Teodori, G. Vitolla, M. Pano, G. Di Giammarco, and A. M. Calafiore Reoperative Coronary Artery Bypass Grafting: Analysis of Early and Late Outcomes Ann. Thorac. Surg., January 1, 2005; 79(1): 81 - 87. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. J. Magee, L. P. Coombs, E. D. Peterson, and M. J. Mack Patient Selection and Current Practice Strategy for Off-pump Coronary Artery Bypass Surgery Circulation, September 9, 2003; 108(90101): II-9 - 14. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. M. Dewey and M. J. Mack Myocardial Revascularization Without Cardiopulmonary Bypass Card. Surg. Adult, January 1, 2003; 2(2003): 609 - 625. [Full Text]
|
|
|
|
 |
|
 M. Mack, D. Bachand, T. Acuff, J. Edgerton, S. Prince, T. Dewey, and M. Magee Improved outcomes in coronary artery bypass grafting with beating-heart techniques J. Thorac. Cardiovasc. Surg., September 1, 2002; 124(3): 598 - 607. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. J. Magee, T. M. Dewey, T. Acuff, J. R. Edgerton, J. F. Hebeler, S. L. Prince, and M. J. Mack Influence of diabetes on mortality and morbidity: off-pump coronary artery bypass grafting versus coronary artery bypass grafting with cardiopulmonary bypass Ann. Thorac. Surg., September 1, 2001; 72(3): 776 - 781. [Abstract] [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
| ANN THORAC SURG | ASIAN CARDIOVASC THORAC ANN | EUR J CARDIOTHORAC SURG |
| J THORAC CARDIOVASC SURG | ICVTS | ALL CTSNet JOURNALS |
