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Redo coronary artery bypass grafting: when and how.
Curr Opin Cardiol
November 2024
Department of Thoracic and Cardiovascular Surgery, Miller Family Heart, Vascular & Thoracic Institute, Cleveland Clinic, Cleveland, Ohio, USA.
Purpose Of Review: Redo coronary artery bypass grafting (CABG) remains technically challenging with significant procedural risk but may be the best option for patients in whom repeat revascularization is indicated. This review summarizes the latest data regarding risk of redo CABG, who should receive this surgery, and how to achieve best outcomes.
Recent Findings: Over the past two decades, the risk of performing redo CABG has declined and is approaching that of primary CABG in the hands of experienced surgeons.
Incidence and healing times of postoperative sternal wound infections: a retrospective observational single-centre study.
Scand Cardiovasc J
December 2024
Department of Cardiothoracic Surgery, Karolinska University Hospital, Stockholm, Sweden.
Analyses of incidence and time required to heal sternal wound infections after heart surgery performed a median sternotomy between 2020 and 2022. Superficial wound infections (SWI) were five times more common (2.7%) than mediastinitis (0.
View Article and Find Full Text PDFSurgical strategies to address re-operative complex left ventricular outflow tract and thoracic aortic pathology: Cleveland Clinic children's experience.
Cardiol Young
December 2023
Division of Pediatric Cardiac Surgery and the Heart, Vascular, and Thoracic Institute, Cleveland Clinic, Cleveland, OH, USA.
Background: Complex patients requiring operations on the left ventricular outflow tract, aortic valve, or thoracic aorta after previous repair of aortopathy constitute a challenging group, with limited information guiding decision-making. We aimed to use our institutional experience to highlight management challenges and describe surgical pearls to address them.
Methods: Forty-one complex patients with surgery on the left ventricular outflow tract, aortic valve, or aorta at Cleveland Clinic Children's between 2016 and 2021 following previous repair of aortic pathology were retrospectively reviewed.
Preparatory stage of interventional extracardiac Fontan.
Multimed Man Cardiothorac Surg
November 2022
Queensland Children's Hospital, Brisbane, Australia.
The extracardiac Fontan can be completed as an interventional procedure when the preparatory stage for Fontan completion is performed at the time of the bidirectional Glenn operation. In this video tutorial, we present the technique for the preparatory stage of an interventional extracardiac Fontan. The interventional aspect offers the advantage of avoiding a redo sternotomy, which involves the risk of cardiac injury, injury to the mediastinal collaterals due to the single-ventricle physiology, the acquired deranged coagulation that may incur morbidity associated with sternal re-entry, and the problems pertinent to cardiopulmonary bypass and/or cardioplegic arrest in this subset of patients.
View Article and Find Full Text PDFModern practice and outcomes of reoperative cardiac surgery.
J Thorac Cardiovasc Surg
December 2022
Department of Thoracic and Cardiovascular Surgery, Heart, Vascular, and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio.
Article Synopsis
- This study evaluates the outcomes of reoperative cardiac surgery with a focus on the timing of cardiopulmonary bypass (CPB) before re-sternotomy in patients at Cleveland Clinic between 2008 and 2017.
- A total of 6,627 patients were analyzed, with procedures mostly involving aortic valve replacement and coronary artery bypass grafting; overall operative mortality was low at 3.5%.
- The analysis found no significant differences in mortality or major complications between early and late CPB groups, indicating that both strategies are effective in a well-coordinated and experienced surgical environment.
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