Re-operative Coronary Artery Bypass Grafting: A Review of Changing Pattern and Outcomes

Kamal S Ayyat,Kenneth R Mccurry,Khaled H Abdelbary,Toshihiro Okamoto,Ahmed M Deebis

doi:10.21767/2471-8041.s1-002

Abstract

Re-operative coronary artery bypass grafting (CABG) prevalence had markedly changed over the last decades. This change had been also noticed in patients’ risk profile and outcomes. The aim of this review is to highlight large multi- and single-center studies investigating the change in pattern, techniques, and outcomes of re-operative CABG globally. It is meant to be a reference that can help cardiac surgeons for a better understanding of our current situation with this challenging operation.

Highlights

Since coronary artery bypass graft (CABG) surgery was introduced for clinical practice in the 1960s, it has demonstrated its efficiency to improve symptoms and prognosis in patients with the advanced coronary atherosclerotic disease [1]
In order to adjust potential longterm benefits of CABG for attrition by death, Blackstone and Lytle examined the outcome of primary CABG patients at Cleveland Clinic in light of three competing time-related events: death, reoperation, and percutaneous transluminal coronary angioplasty (PTCA)
In van Domburg and colleagues’ 30-year follow-up study of 1041 primary venous CABG, coronary reinterventions were performed in 36% of the patients. 29.6% had re-operative CABG and 14.2% had PTCA

Summary

Introduction

Since coronary artery bypass graft (CABG) surgery was introduced for clinical practice in the 1960s, it has demonstrated its efficiency to improve symptoms and prognosis in patients with the advanced coronary atherosclerotic disease [1]. A number of improvements have been made in the pre-, intra-, and postoperative management of re-operative CABG patients over the last decades. These improvements have included technological developments as well as the increased experience of the teams treating these patients (cardiology, anesthesia, intensive care, and surgical teams). Keywords used in the search included MeSH terms: reoperative coronary artery bypass grafting, incidence, patient characteristics, trend, pattern, and outcome

Objectives

Results

Conclusion