Long-term follow-up after coronary artery bypass grafting reoperation

Background: Coronary artery bypass grafting (CABG) reoperation is being per formed with increasing frequency, Objective: To determine the clinical outcome and the long-term results of a second CABG. Setting: An 1100-bed urban university-affiliated hospital. Design: Retrieval of data on selected parameters from medical records befor e surgery and prospective follow-up afterwards. Patients and methods: We studied the outcomes of 498 consecutive patients w ho underwent CABG reoperation in our institution from January 1978 to Decem ber 1989 and who were followed postoperatively. Their perioperative mortali ty, morbidity, and long-term follow-up results were re-evaluated. The end p oints of the study were December 1997, 15 years of follow-up, or the patien t's death. Results: The perioperative mortality rate was 3%. The cumulative survival r ates were 90.1%, 74%, and 63.4% at the 5-year, 10-year, and 15-year follow- ups, respectively. The cardiac event-free survival rates were 91.5%, 83.4%, and 67.8% at the 5-year, 10-year, and 15-year follow-ups, respectively. Th e risk factors adversely affecting long-term survival were advanced age, hy pertension, and a low left ventricular ejection fraction (LVEF). Conclusions: The long-term results of cumulative survival and cardiac event -free survival in patients who underwent CABG reoperation are good. Althoug h this reoperation is safe overall, advanced age, hypertension, and a decre ased LVEF significantly increase the surgical risk.