Background. The minimally invasive direct coronary artery bypass (MIDCAB) p
rocedure, using a small anterolateral thoracotomy without cardiopulmonary b
ypass, has been recommended for high-risk patients because it is less traum
atic than conventional coronary artery bypass grafting. For redo patients w
ho have patent grafts and pericardial adhesions, the MIDCAB may be preferab
le to the conventional operation because manipulation of the graft and diss
ection of adhesions may be minimized.
Methods. Since November 1995, 120 patients underwent the MIDCAB procedure i
n our institution. Among these patients, there were 25 redo cases (20.8%).
We reviewed these redo cases and studied their surgical results (mortality,
morbidity, hospital stay, operation time, and postoperative inotropic supp
ort). To clarify the usefulness of this procedure, we compared the results
of redo operations with those of the first-time operations.
Results. For redo MIDCAB, there was one operative death (4%) because of int
estinal infarction. The mean hospital stay was 4.3 days and the number of p
atients who needed postoperative positive inotropic agents was 3 (12%). The
re was no significant differences between redo and first-time operation pat
ients in mortality, morbidity, hospital stay, operation time, and postopera
tive inotropic support.
Conclusions. Results of the MIDCAB procedure for redo patients were compara
ble to those for primary MIDCAB operations. (C) 1999 by The Society of Thor
acic Surgeons.