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

Heart Surg Forum

Division of Cardiothoracic Surgery and the Center for Minimally Invasive Cardiac Surgery, Kaleida Health-Buffalo General Hospital Site and SUNY at Buffalo, Buffalo, New York 14203, USA.

Published: November 2000

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.

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