Posterior thoracotomy for reoperative coronary artery bypass grafting without cardiopulmonary bypass: perioperative results

Heart Surg Forum. 2000;3(1):18-22; discussion 22-3.

Abstract

Background: This retrospective study evaluates morbidity and mortality of reoperative coronary artery bypass grafting (CABG) without cardiopulmonary bypass (CPB) using a posterior thoracotomy to revascularize the lateral aspect of the heart.

Methods: From January 1995 to July 1999, reoperative CABG without CPB was performed on 67 selected patients using a left posterior thoracotomy approach. Preoperative risk factors, postoperative mortality, and major complications were derived from the New York State database.

Results: All patients were operated on without CPB. A total of 1.3 grafts per patient were performed. Freedom from major complications was 95.5%. There were no postoperative cerebro-vascular accidents (CVA) or new neurological deficits. Two patients (3%) had a perioperative acute myocardial infarction. The actual mortality rate was 4.5% (3/67), the expected mortality was 5.1% and the calculated risk adjusted mortality was 2.1%.

Conclusions: Reoperative CABG without CPB to revascularize selected coronary artery targets can be safely performed using a posterior thoracotomy approach.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Cardiopulmonary Bypass
  • Coronary Artery Bypass / methods*
  • Coronary Artery Bypass / mortality
  • Female
  • Humans
  • Male
  • Middle Aged
  • New York / epidemiology
  • Postoperative Complications / epidemiology
  • Reoperation
  • Retrospective Studies
  • Survival Rate
  • Thoracotomy / methods*
  • Thoracotomy / mortality
  • Treatment Outcome