Document Detail


Alternative approaches in off-pump redo coronary artery bypass grafting.
MedLine Citation:
PMID:  11074974     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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:
T A Vassiliades; J L Nielsen
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  The heart surgery forum     Volume:  3     ISSN:  1098-3511     ISO Abbreviation:  Heart Surg Forum     Publication Date:  2000  
Date Detail:
Created Date:  2006-04-26     Completed Date:  2006-05-11     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  100891112     Medline TA:  Heart Surg Forum     Country:  United States    
Other Details:
Languages:  eng     Pagination:  203-6     Citation Subset:  IM    
Affiliation:
Pensacola Heart Institute, 5147 North Ninth Avenue, Suite 401, Pensacola, Florida 32504, USA. Vassiliades@pol.ne
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Coronary Artery Bypass, Off-Pump / methods*
Coronary Disease / surgery*
Female
Follow-Up Studies
Humans
Male
Middle Aged
Retrospective Studies
Surgical Procedures, Minimally Invasive / methods*
Thoracotomy
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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