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The Annals of Thoracic Surgery, Vol 55, 486-489, Copyright © 1993 by The Society of Thoracic Surgeons
WJ Fanning, GS Kakos and TE Williams Jr
Between June 1979 and January 1992, 46 men and 13 women aged 35 to 81 years
(mean, 58 years) underwent reoperative coronary artery bypass grafting
without cardiopulmonary bypass. Isolated reoperative circumflex bypass was
performed through a left thoracotomy, and reoperative bypass to the right
coronary artery and left anterior descending coronary systems was through a
median sternotomy. Complete revascularization was the goal in all patients.
Saphenous vein grafts were placed to the right coronary artery (n = 21),
circumflex artery (n = 11), and left anterior descending artery (n = 24),
and 14 internal thoracic artery to left anterior descending artery bypass
grafts were performed. The overall mortality rate was 3.4% (2 deaths).
Postoperative morbidity included myocardial infarction in 1 patient and
pleuropulmonary complications in 6. No patient was reexplored for
hemorrhage, and 19 patients required no blood products. Twenty patients
underwent repeat coronary angiography, and 18 of 20 grafts placed without
cardiopulmonary bypass were patent. At a mean follow-up interval of 42.2
months 35 of 50 evaluable patients were in functional class I or II. In
selected patients, reoperative coronary artery bypass grafting can be
performed without cardiopulmonary bypass with a low perioperative morbidity
and mortality rate, satisfactory graft patency rates, and good long-term
symptomatic improvement.
ARTICLES
Reoperative coronary artery bypass grafting without cardiopulmonary bypass
Division of Thoracic Surgery, Grant Medical Centers, Columbus, Ohio.
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