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KMID : 0364020090420040456
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Korean Journal of Thoracic and Cardiovascular Surgery
2009 Volume.42 No. 4 p.456 ~ p.463
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Redo CABG Using Various Arterial Grafts
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Min Ho-Gi
Sung Ki-Ick
Park Pyo-Won
Lee Young-Tak
Jun Tae-Gook
Kim Wook-Sung
Lee Mi-Na
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Abstract
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Background : Although the reports on re-operative coronary revascularization (redo-CABG) have increased, there are only limited reports on redo-CABG using arterial grafts. The aim of this study was to analyze the safety and feasibility of using various arterial grafts for redo-CABG.
Materials and Methods :A consecutive series of patients who underwent 33 redo-CABGs from March 2001 to July 2008 were retrospectively reviewed. We performed conventional CABG in 17 patients, on-pump beating CABG in 7, off-pump CABG in 7 and minimally invasive direct coronary artery bypass in 2. The grafted that were used included 34 internal thoracic arteries (ITA), 14 radial arteries, 14 right gastroepiploic arteries and others. Arterial composite grafts were constructed in 26 patients. Of these, a previously patent in-situ left ITA was re-used as the in-flow of a composite graft in 10 patients.
Results :No hospital deaths or major wound problems occurred. The post-operative complications included 2 myocardial infarctions (6%), 1 intra-aortic balloon pump insertion (3%), 5 cases of atrial fibrillation (15.1%) and 3 neurologic complications (9.1%). The mean follow-up duration was 31.1±22.7 months and the 3 year survival rate was 86.4%. There were 4 late deaths (2 cardiac deaths) and no recurrent angina during the follow-up period.
Conclusion :Redo-CABG with using various arterial grafts is currently a safe, feasible procedure, but further investigation and long term follow-up are needed. (Korean J Thorac Cardiovasc Surg 2009;42:456-463)
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KEYWORD
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Reoperation, Coronary artery bypass surgery
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