Late outcome of reoperative coronary revascularization on the beating heart

Background: Reoperative (redo) coronary artery bypass grafting (CABG) is as sociated with a higher morbidity and mortality than first-time CABG. An off -cardiopulmonary bypass (off-pump) approach to redo CABG, however, may pote ntially benefit redo patients. The aim of the present report is to describe the early and long-term clinical outcome of patients who underwent off-pum p redo CABG between July 1985 and January 1999 in our institution. Methods: Redo patients (n = 138) represented 13% of patients who had off-pu mp CABG during the period of study (n = 1072). Mean patient age was 63 +/- 12 years, and 67% were men. Surgical approaches included median sternotomy (n = 93, 67%), anterior (n = 20, 15%) and lateral (n = 25, 18%) minimally i nvasive direct coronary artery bypass (MIDCAB). Results: Operative mortality was 2% (n = 3). Target lesion re-intervention was 6% (n = 9) Actuarial survival at a mean period of follow-up of 2.5 +/- 1 year (range: 1 month to 11 years) was 83%. Event-free survival (freedom f rom death, myocardial infarction, and repeat intervention) was 67%. Overall cardiac-related mortality was 10% (n = 14). Conclusion: Off-pump redo CABG can be safely performed with a relatively lo w mortality rate and a low rate of target lesion revascularization.