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Alternative approaches in off-pump redo coronary artery bypass grafting.
Heart Surg Forum. 2000; 3(3):203-6.HS

Abstract

BACKGROUND

The recent development of off-pump and minimally invasive techniques in coronary artery bypass grafting (CABG) has provided the surgeon with multiple options in performing redo revascularization procedures.

METHODS

We retrospectively analyzed our early results in off-pump redo CABG procedures. Between January 1998 and January 2000, we performed 55 off-pump redo CABG procedures: 25 through a full sternotomy, 21 through a left posterolateral thoracotomy, 5 using a lower hemi-sternotomy and 4 using a mini anterior thoracotomy with thoracoscopic internal mammary artery harvesting. The mean age of this group was 67.7 years (range 37-85). The mean number of grafts performed in earlier operations was 2.7 (range 1-6) with 51% of grafts still partially or fully open at the time of re-operation. Twenty-six patients (47.3%) had a functioning left internal mammary artery graft to left anterior descending. Preoperative clinical severity scoring predicted a mortality of 9% and morbidity of 30%.

RESULTS

There were no operative or thirty-day infarctions or deaths. Morbidity included pulmonary complications (8), renal failure (1) and bleeding (1) for a total complication rate of 18.9%. The average number of grafts performed was 2.7 (range 1-5) for sternotomy patients and 1.4 (range 1-3) for thoracotomy patients.

CONCLUSIONS

By employing alternative approaches in performing off-pump redo CABG procedures, the surgeon can often avoid injury to pre-existing patent internal mammary grafts as well as the morbidity associated with the use of cardiopulmonary bypass.

Authors+Show Affiliations

Pensacola Heart Institute, 5147 North Ninth Avenue, Suite 401, Pensacola, Florida 32504, USA. Vassiliades@pol.neNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

11074974

Citation

Vassiliades, T A., and J L. Nielsen. "Alternative Approaches in Off-pump Redo Coronary Artery Bypass Grafting." The Heart Surgery Forum, vol. 3, no. 3, 2000, pp. 203-6.
Vassiliades TA, Nielsen JL. Alternative approaches in off-pump redo coronary artery bypass grafting. Heart Surg Forum. 2000;3(3):203-6.
Vassiliades, T. A., & Nielsen, J. L. (2000). Alternative approaches in off-pump redo coronary artery bypass grafting. The Heart Surgery Forum, 3(3), 203-6.
Vassiliades TA, Nielsen JL. Alternative Approaches in Off-pump Redo Coronary Artery Bypass Grafting. Heart Surg Forum. 2000;3(3):203-6. PubMed PMID: 11074974.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Alternative approaches in off-pump redo coronary artery bypass grafting. AU - Vassiliades,T A,Jr AU - Nielsen,J L, PY - 2000/06/21/accepted PY - 2000/11/14/pubmed PY - 2006/5/12/medline PY - 2000/11/14/entrez SP - 203 EP - 6 JF - The heart surgery forum JO - Heart Surg Forum VL - 3 IS - 3 N2 - BACKGROUND: The recent development of off-pump and minimally invasive techniques in coronary artery bypass grafting (CABG) has provided the surgeon with multiple options in performing redo revascularization procedures. METHODS: We retrospectively analyzed our early results in off-pump redo CABG procedures. Between January 1998 and January 2000, we performed 55 off-pump redo CABG procedures: 25 through a full sternotomy, 21 through a left posterolateral thoracotomy, 5 using a lower hemi-sternotomy and 4 using a mini anterior thoracotomy with thoracoscopic internal mammary artery harvesting. The mean age of this group was 67.7 years (range 37-85). The mean number of grafts performed in earlier operations was 2.7 (range 1-6) with 51% of grafts still partially or fully open at the time of re-operation. Twenty-six patients (47.3%) had a functioning left internal mammary artery graft to left anterior descending. Preoperative clinical severity scoring predicted a mortality of 9% and morbidity of 30%. RESULTS: There were no operative or thirty-day infarctions or deaths. Morbidity included pulmonary complications (8), renal failure (1) and bleeding (1) for a total complication rate of 18.9%. The average number of grafts performed was 2.7 (range 1-5) for sternotomy patients and 1.4 (range 1-3) for thoracotomy patients. CONCLUSIONS: By employing alternative approaches in performing off-pump redo CABG procedures, the surgeon can often avoid injury to pre-existing patent internal mammary grafts as well as the morbidity associated with the use of cardiopulmonary bypass. SN - 1098-3511 UR - https://www.unboundmedicine.com/medline/citation/11074974/Alternative_approaches_in_off_pump_redo_coronary_artery_bypass_grafting_ DB - PRIME DP - Unbound Medicine ER -