HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Enoch Akowuah Sanjay Theodore Gilbert C. Shardey Peter D. Skillington James Tatoulis Michael Yii Julian A. Smith Morteza Mohajeri Adrian Pick Siven Seevanayagam Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Yap, C.-H. Articles by Reid, C. M. Search for Related Content PubMed PubMed Citation Articles by Yap, C.-H. Articles by Reid, C. M. Related Collections Coronary disease Related Article

---

Original Articles: Adult Cardiac

Contemporary Results Show Repeat Coronary Artery Bypass Grafting Remains a Risk Factor for Operative Mortality

^a Department of Epidemiology and Preventive Medicine, Monash University, Victoria
^e Department of Surgery, Monash University, Victoria
^b Department of Cardiothoracic Surgery, The Royal Melbourne Hospital, Melbourne, Australia
^c Monash Medical Centre, Melbourne, Australia
^d St. Vincent's Hospital, Melbourne, Australia
^f Geelong Hospital, Victoria, Australia
^g Alfred Hospital, Victoria, Australia
^h Austin Hospital, Victoria, Australia

Accepted for publication February 3, 2009.

^_* Address correspondence to Dr Yap, Department of Cardiothoracic Surgery, The Royal Melbourne Hospital, Parkville, Victoria, 3050, Australia (Email: cheng-hon.yap{at}mh.org.au).

Background: Reoperative coronary artery bypass grafting (redo CABG) shows improving outcomes, but with varying degrees of improvement. We assessed contemporary outcomes after redo CABG to determine if redo status is still a risk factor for early postoperative complications and midterm survival.

Methods: Isolated CABG procedures (June 1, 2001 to May 31, 2008) within the Australasian Society of Cardiac and Thoracic Surgeons Cardiac Surgery Database were included. Redo status as a predictor for early outcomes was assessed with logistic regression analysis. Midterm survival was determined from the National Death Index. Effect of redo status on midterm survival was assessed using a Cox proportional hazards model.

Results: Inclusion criteria were met by 13,436 patients, and 458 (3.4%) underwent redo CABG. Operative mortality was 4.8% for redo CABG and 1.8% for first-time CABG (p < 0.001). After adjustment, redo status remained a predictor for operative mortality (odds ratio [OR], 2.1; 95% confidence interval [CI], 1.3 to 3.6), myocardial infarction (OR, 2.8; 95% CI, 1.6 to 6.0), and prolonged ventilation (OR, 1.5; 95% CI, 1.1 to 2.0). Unadjusted survival was lower for the redo CABG group vs the first-time CABG group at up to 6 years (p = 0.01, log-rank test. After adjusting for differences in patient variables, redo status was not a predictor of midterm survival (OR, 1.03; 95% CI, 0.78 to 1.35; p = 0.85).

Conclusions: Early postoperative outcomes of redo CABG are encouraging. Midterm survival is excellent; however, redo remains a significant risk factor for operative mortality in contemporary practice.

Related Article

Invited Commentary

Alfred Tector
Ann. Thorac. Surg. 2009 87: 1391. [Extract] [Full Text] [PDF]

This article has been cited by other articles:

				R. K. Ghanta, T. Kaneko, J. S. Gammie, S. Sheng, and S. F. Aranki Evolving trends of reoperative coronary artery bypass grafting: An analysis of the Society of Thoracic Surgeons Adult Cardiac Surgery Database J. Thorac. Cardiovasc. Surg., February 1, 2013; 145(2): 364 - 372. [Abstract] [Full Text] [PDF]

				K. Takahashi, S. Takeuchi, K. Ito, M. Chiyoya, N. Kondo, and M. Minakawa Reoperative Coronary Artery Bypass Surgery: Avoiding Repeat Median Sternotomy Ann. Thorac. Surg., December 1, 2012; 94(6): 1914 - 1919. [Abstract] [Full Text] [PDF]

				T. J. George, C. A. Beaty, G. A. Ewald, S. D. Russell, A. S. Shah, J. V. Conte, G. J. Whitman, and S. C. Silvestry Reoperative Sternotomy Is Associated With Increased Mortality After Heart Transplantation Ann. Thorac. Surg., December 1, 2012; 94(6): 2025 - 2032. [Abstract] [Full Text] [PDF]

				S. Launcelott, M. Ouzounian, K. J. Buth, and J.-F. Legare Predicting In-Hospital Mortality After Redo Cardiac Operations: Development of a Preoperative Scorecard Ann. Thorac. Surg., September 1, 2012; 94(3): 778 - 784. [Abstract] [Full Text] [PDF]

				K. D. Algarni, A. M. Elhenawy, M. Maganti, S. Collins, and T. M. Yau Decreasing prevalence but increasing importance of left ventricular dysfunction and reoperative surgery in prediction of mortality in coronary artery bypass surgery: Trends over 18 years J. Thorac. Cardiovasc. Surg., August 1, 2012; 144(2): 340 - 346.e1. [Abstract] [Full Text] [PDF]

				Writing Committee Members, L. D. Hillis, P. K. Smith, J. L. Anderson, J. A. Bittl, C. R. Bridges, J. G. Byrne, J. E. Cigarroa, V. J. DiSesa, L. F. Hiratzka, et al. 2011 ACCF/AHA Guideline for Coronary Artery Bypass Graft Surgery: A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines Circulation, December 6, 2011; 124(23): e652 - e735. [Full Text] [PDF]

				D. S. Likosky, S. D. Surgenor, R. S. Kramer, L. Russo, B. J. Leavitt, M. J. Sorensen, R. E. Helm, G. L. Sardella, F. V. DiPierro, Y. R. Baribeau, et al. Effect of Prior Cardiac Operations on Survival After Coronary Artery Bypass Grafting Ann. Thorac. Surg., October 1, 2011; 92(4): 1260 - 1267. [Abstract] [Full Text] [PDF]

				A. Tector Invited Commentary Ann. Thorac. Surg., May 1, 2009; 87(5): 1391 - 1391. [Full Text] [PDF]