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Ten-year experience with single-vessel and multivessel reoperative off-pump coronary artery bypass grafting.
J Thorac Cardiovasc Surg. 2008 Mar; 135(3):527-32.JT

Abstract

OBJECTIVE

Patients undergoing reoperative coronary artery bypass have increased mortality and morbidity compared with those undergoing primary coronary bypass. The experience in applying off-pump techniques to coronary reoperations is limited. In this article we report a 10-year experience using various techniques of reoperative off-pump coronary bypass.

METHODS

Between January 1996 and December 2005, 332 patients underwent reoperative off-pump coronary artery bypass grafting. Data were collected regarding the preoperative, intraoperative, and postoperative clinical course of all patients. These were compared with similar data obtained from patients who had undergone conventional coronary reoperation during this period.

RESULTS

Two hundred ninety-six (89.2%) male and 36 female patients underwent reoperative off-pump coronary artery bypass. Of these, 265 (79.8%) patients underwent multivessel bypass through a median sternotomy, an anterolateral thoracotomy was performed in 63 (19%) patients, and a posterolateral thoracotomy was performed in 4 (1.2%) patients. The early mortality for patients undergoing off-pump surgery was lower than for those undergoing conventional reoperations (3.3% vs 5.5%, P = .066). Those who had undergone off-pump reoperations had less need for prolonged ventilation or prolonged inotropic support and had shorter intensive care unit and hospital stays than patients who had undergone redo coronary artery bypass grafting.

CONCLUSION

For many patients requiring coronary reoperations, off-pump techniques are safe and feasible. Complete revascularization was achieved in at least 75% of patients in an unselected population, with mortality and perioperative event rates that are comparable with those of conventionally performed coronary reoperations.

Authors+Show Affiliations

Escorts Heart Institute and Research Centre, New Delhi, India. dryugal@yahoo.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Evaluation Study
Journal Article

Language

eng

PubMed ID

18329464

Citation

Mishra, Yugal K., et al. "Ten-year Experience With Single-vessel and Multivessel Reoperative Off-pump Coronary Artery Bypass Grafting." The Journal of Thoracic and Cardiovascular Surgery, vol. 135, no. 3, 2008, pp. 527-32.
Mishra YK, Collison SP, Malhotra R, et al. Ten-year experience with single-vessel and multivessel reoperative off-pump coronary artery bypass grafting. J Thorac Cardiovasc Surg. 2008;135(3):527-32.
Mishra, Y. K., Collison, S. P., Malhotra, R., Kohli, V., Mehta, Y., & Trehan, N. (2008). Ten-year experience with single-vessel and multivessel reoperative off-pump coronary artery bypass grafting. The Journal of Thoracic and Cardiovascular Surgery, 135(3), 527-32. https://doi.org/10.1016/j.jtcvs.2007.10.019
Mishra YK, et al. Ten-year Experience With Single-vessel and Multivessel Reoperative Off-pump Coronary Artery Bypass Grafting. J Thorac Cardiovasc Surg. 2008;135(3):527-32. PubMed PMID: 18329464.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Ten-year experience with single-vessel and multivessel reoperative off-pump coronary artery bypass grafting. AU - Mishra,Yugal K, AU - Collison,Sathiakar Paul, AU - Malhotra,Rajneesh, AU - Kohli,Vijay, AU - Mehta,Yatin, AU - Trehan,Naresh, PY - 2007/04/28/received PY - 2007/10/05/revised PY - 2007/10/19/accepted PY - 2008/3/11/pubmed PY - 2008/4/5/medline PY - 2008/3/11/entrez SP - 527 EP - 32 JF - The Journal of thoracic and cardiovascular surgery JO - J Thorac Cardiovasc Surg VL - 135 IS - 3 N2 - OBJECTIVE: Patients undergoing reoperative coronary artery bypass have increased mortality and morbidity compared with those undergoing primary coronary bypass. The experience in applying off-pump techniques to coronary reoperations is limited. In this article we report a 10-year experience using various techniques of reoperative off-pump coronary bypass. METHODS: Between January 1996 and December 2005, 332 patients underwent reoperative off-pump coronary artery bypass grafting. Data were collected regarding the preoperative, intraoperative, and postoperative clinical course of all patients. These were compared with similar data obtained from patients who had undergone conventional coronary reoperation during this period. RESULTS: Two hundred ninety-six (89.2%) male and 36 female patients underwent reoperative off-pump coronary artery bypass. Of these, 265 (79.8%) patients underwent multivessel bypass through a median sternotomy, an anterolateral thoracotomy was performed in 63 (19%) patients, and a posterolateral thoracotomy was performed in 4 (1.2%) patients. The early mortality for patients undergoing off-pump surgery was lower than for those undergoing conventional reoperations (3.3% vs 5.5%, P = .066). Those who had undergone off-pump reoperations had less need for prolonged ventilation or prolonged inotropic support and had shorter intensive care unit and hospital stays than patients who had undergone redo coronary artery bypass grafting. CONCLUSION: For many patients requiring coronary reoperations, off-pump techniques are safe and feasible. Complete revascularization was achieved in at least 75% of patients in an unselected population, with mortality and perioperative event rates that are comparable with those of conventionally performed coronary reoperations. SN - 1097-685X UR - https://www.unboundmedicine.com/medline/citation/18329464/Ten_year_experience_with_single_vessel_and_multivessel_reoperative_off_pump_coronary_artery_bypass_grafting_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0022-5223(07)01727-8 DB - PRIME DP - Unbound Medicine ER -