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Contains fulltext : 57537.pdf (Publisher’s version ) (Closed access) OBJECTIVE: Despite advances in cardiac surgery, the risk of reoperative coronary artery bypass surgery (RECABG) still exceeds those of a primary myocardial revascularization and also the late results are not so favourable. In this study, long-term cardiac survival is analyzed. METHODS: We analyzed long-term cardiac survival of 466 patients who survived the first 6 months after a RECABG between January 1987 and December 1998. Actuarial survival estimates were calculated and pre- and peroperative variables were analyzed to identify predictors of long-term cardiac related mortality. RESULTS: Mean follow-up was 7.7 +/- 3.8 years (1-17 years), and follow-up was 95.6% complete. One-year cardiac survival was 98.2%, 5-year: 91.0%, 10-year: 78.7% and 14-year survival 60.2%. Cardiac survival was only significantly superior for patients under 65 years of age at the moment of the RECABG. Impaired left ventricular function was identified as the only independent predictor of late cardiac-related mortality. CONCLUSION: The long-term survival in patients undergoing RECABG is acceptable. Once patients survived the first 6 postoperative months, advanced age (>65 years) is affecting long-term cardiac survival and impaired left ventricular function is the only independent predictor of late cardiac mortality.

Objective: To outline the changes of the patient population undergoing redo-coronary artery bypass surgery (RECABG). Methods: Preoperative data of 582 first RECABGs, January 1987‐June 2000 were analyzed. Group A: 1987‐1991 ðn ¼ 193Þ; group B: 1992‐1995 ðn ¼ 201Þ; and group C: 1996‐June 2000 ðn ¼ 188Þ. Results: These 582 RECABGs represent about 8.5% of the performed bypass surgeries during this period. Mean age ðP ¼ ,0:001Þ, percentage of patients with kidney disease ðP ¼ 0:001Þ, a preoperative PTCA ðP , 0:001Þ increased. Significant more elective operations ðP , 0:001Þ and lesser urgent operations ðP ¼ 0:001Þ were performed in group C. There is a significant different distribution of vessel disease over the three periods ðP ¼ 0:04Þ. Significant more patients had a patent IMA graft ðP , 0:001Þ. The angina-free period after CABG ðP , 0:001Þ, the time period between both operations ðP , 0:001Þ and the period between the new onset of angina and the RECABG ðP ¼ 0:012Þ increased significantly. Despite the importance of progression of atherosclerosis of any sort decrease significantly ðP , 0:001Þ over the whole study, there is a significant increase of patients reoperated for isolated progression of the disease in the native coronary arteries ðP , 0:001Þ in group C. The impact of late GF was not different for the total group ðP ¼ 0:82Þ, however, the percentage of RECABGs for isolated late GF increased significantly between group A and B ðP , 0:001Þ but there was a decrease from B to C, however, not significant ðP ¼ 0:067Þ. Conclusion: During the past few years there is a trend in RECABG of older patients, with more coexisting diseases. There are an increasing number of patients with patent arterial grafts, an increase of the event-free period after the CABG, the period between the CABG and RECABG and of the time period between the onset of new angina and the RECABG. Although the impact of atherosclerosis, as angiographic indication, decreased over the total group, there is the significant increase of the percentage of patients reoperated because of isolated progression of atherosclerosis in the native coronary arteries. q 2002 Elsevier Science B.V. All rights reserved.