ISSN : 1301-5680
e-ISSN : 2149-8156
TURKISH JOURNAL OF
THORACIC AND
CARDIOVASCULAR SURGERY
Turkish Journal of Thoracic and Cardiovascular Surgery     
CORONARY RE-REVASCULARIZATION
Kaan KIRALİ, Denyan MANSUROĞLU, Altuğ TUNCER, Nihan KAYALAR, Esat AKINCI, Mehmet BALKANAY, Gökhan İPEK, Ömer IŞIK, Cevat YAKUT
Koşuyolu Kalp Eğitim ve Araştırma Hastanesi, Kalp-Damar Cerrahisi Kliniği, İSTANBUL
Background:

Coronary reoperations are used very often for the treatment of graft occlusion performed in the primary operation. The aim of this study is to determine the results of the coronary reoperations.

Methods:

Forty coronary reoperations have been performed in our department until December 2000. Thirty-five patients (87.5%) were male and five were (12.5%) female with a mean age 56.2 ± 8.3 (39-69) years. The mean interval between two procedures was 5.4 ± 4.6 (0.5-14) years. Mean follow-up period was 2.3 ± 1.4 years. Arterial grafts were found occluded angiographically.

Results:

Early mortality was 2.5% with one patient. There was no late mortality. The mean number of the bypassed graft in the second operation was 1.5 ± 0.7 (1-3) and the number of the first operation was 2 ± 0.9 (1-4), the difference was significant (p = 0.007). Off-pump bypass surgery was used mostly in the reoperations (27 / 40; 67.5%) than the primary operations (10 / 40; 25%) (p = 0.006). LIMA, which had not been used in the primary operation, was harvested in 5 patients for LAD re-revascularization, while saphenous vein or other arterial grafts were used for LAD re-revascularization in the others. Only in 7 patients (20%) there was a new developed atherosclerotic stenosis at the other coronary arteries, which had not been bypassed in the primary operation.

Conclusions:

Coronary reoperations are very safe and effective procedures. In spite of surgeon can prefer the type of graft for re-revascularization, most surgeons prefer arterial grafts. Incomplete re-revascularization with only LAD - revascularization on the beating heart will improve the quality of patient-life and outcome of coronary reoperations.

Keywords : Reoperation, beating heart, arterial graft, incomplet revascularization
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