Posterior Thoracotomy for Reoperative Coronary Artery Bypass Grafting without Cardiopulmonary Bypass: Perioperative Results

(#2000-0712 ... February 16, 2000)

Giuseppe D'Ancona, MD, Hratch Karamanoukian, MD, Thomas Lajos, MD, Marco Ricci, MD, Jacob Bergsland, MD, Tomas Salerno, MD

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

ABSTRACT

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.

AUTHOR/ARTICLE INFORMATION

Reprint requests to: Hratch Karamanoukian, MD, Kaleida Health–Buffalo General Hospital Site, 100 High Street, Buffalo, New York 14203; Phone: (716) 859-1080, Fax: (716) 859-4687

Submitted on: February 15, 2000; Accepted on: February 16, 2000