Reoperation for recurrent coronary artery disease: results of 200 consecutive cases.

Y Shimada, A Dixit, G Fermanis, D Horton
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引用次数: 7

Abstract

BACKGROUND It is well known that reoperation for recurrent coronary artery disease is more difficult than primary coronary artery bypass grafting. However, it is possible to reduce the morbidity and mortality of reoperation to the same level as the initial procedure with careful surgical technique. METHODS A retrospective study of the first 200 patients who underwent redo coronary bypass grafting was undertaken. RESULTS In the first 200 cases of redo coronary bypass grafting at St George Hospital, Sydney (August 1986-January 1995), there were five in-hospital deaths (2.5%). There was one case of sternal infection (0.5%), which required surgical debridement, three cases of stroke (1.5%), one case of postoperative bleeding (0.5%), which required a return to theatre and six cases (3%) required mechanical ventilation for more than 24 h. The need for major postoperative support (such as intra-aortic balloon pumping/adrenaline infusion) was significantly affected by the degree of urgency and the degree of pre-operative ventricular impairment. CONCLUSIONS The mortality rate of redo coronary artery bypass grafting in this series is similar to that of primary surgery described in other reports.
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再手术治疗复发性冠状动脉疾病200例分析
背景:众所周知,复发性冠状动脉疾病的再手术比初次冠状动脉旁路移植术更困难。然而,通过仔细的手术技术,有可能将再次手术的发病率和死亡率降低到与初次手术相同的水平。方法:对前200例再次行冠状动脉旁路移植术的患者进行回顾性研究。结果:1986年8月~ 1995年1月在悉尼圣乔治医院行冠状动脉旁路移植术的前200例患者中,有5例住院死亡(2.5%)。胸骨感染1例(0.5%)需要手术清创,卒中3例(1.5%),术后出血1例(0.5%)需要返回手术室,机械通气6例(3%)需要超过24小时。术后主要支持(如主动脉内球囊泵送/肾上腺素输注)的需求受急迫性程度和术前心室损伤程度的显著影响。结论:本研究中再次行冠状动脉旁路移植术的死亡率与其他报道中描述的初次手术相似。
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