2Department of Cardiology Surgery İstanbul Memorial Hospital, İstanbul, Turkey
Abstract
Background: Repetitive procedures usually take place in the natural course of coronary heart disease. The aim of this study was to evaluate the risk factors, which affect coronary bypass reoperations, and to compare them with the postoperative results of the coronary first operations and the reoperations. Methods: Between January 1995 and January 2000, coronary reoperations were performed in 104 cases (Coronary reoperations group) by the same surgical team. Ninety-nine of them were the first, 3 were the second and 2 were the third reoperations in this group. At the same period of time, 3609 patients underwent coronary bypass procedure as the first operation (Coronary 1. operation group). Eighty-seven patients were male (83.65%), 17 were female (16.35%) and the mean age was 60.82 ± 9.49 in reoperation group; while among 2916 patients 2223 were male (80.8%), 693 were female (19.2%) and the mean age was 60.37±9.58 in the first operation group. Results: Incidence of prolonged ventilation (p-=0.0001), renal dysfunction requiring dialysis (p=0.01), need for intraaortic balloon pump (p=0.0001) and prolonged intensive care unit (p=0.01) and hospital stay (p=0.01) were significantly higher in reoperation group. The mortality rate was 9.62 % in the reoperation group while it was 2.2 % in the first operation group (p=0.0001). Conclusions: The high morbidity and mortality of coronary bypass reoperations can be reduced to acceptable levels accordingly with early therapy prior to ventricular dysfunction and clinical deterioration that will improve the outcome in these patients.