Coronary by-pass reoperations without cardiopulmonary by-pass: The Israeli experience

Y. Moshkovitz, L. Sternik, R. Mohr

Research output: Contribution to journalArticlepeer-review

Abstract

Objectives. To evaluate results of coronary artery bypass grafting (CABG) reoperations without cardiopulmonary by-pass (CPB). Materials and methods. Thirty-two patients underwent CABG reoperation with CPB between December 1991 and December 1993. There were 29 (91%) males, and 3 (9%) females. Mean age was 62 ± 7 years. Five (16%) were operated on emergently, two (6%) of them during cardiogenic shock. Three (9%) were referred for operation up to two weeks following acute MI. Six (19%) had preoperative EF < 35%. Significant associated systemic diseases included previous CVA in two patients (6%), calcified aorta in two (6%), peripheral vascular disease in six (19%), renal failure in one (3%), and severe COPD in one (3%). Mean number of grafts/pt was 1.5 (range 1-3), and IMA was used in 26 (81%) of patients. Only nine patients (28%) received a graft to a circumflex marginal artery, six (66%) of whom were operated on through left thoracotomy. Results. Only two patients (6%) had low output syndrome postoperatively; one was supported with catecholamines, and the other with intraaortic balloon pump. Hospital stay was 6.1 ± 1.5 days (mean ± SD). Early unfavorable outcome included operative death in one patient (3.1%), non-fatal MI in two (6%), and sternal infection in one (3%). Follow-up (10 ± 5 months, mean ± SD) showed two late deaths (one cardiac, and one carcinoma), one (3%) non-fatal MI, and return of angina in three (9%) patients. Conclusions. CABG reoperations without CPB should be considered, particularly for revascularization of the LGD and RCA systems. Left thoracotomy is optional for patients with disease confined to circumflex and LAD systems.

Original languageEnglish
Pages (from-to)59-62
Number of pages4
JournalJournal of Cardiovascular Surgery
Volume35
Issue numberSUPPL. 1-6
StatePublished - 1994
Externally publishedYes

Keywords

  • Cardiopulmonary by-pass
  • Coronary artery by-pass grafting

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