Redo Coronary Artery Bypass Grafting: On-Pump and Off-Pump Coronary Artery Bypass Grafting Revascularization Techniques

Objective To analyze the short-term outcomes of redo coronary artery bypass grafting (CABG) using on-pump and off-pump CABG techniques. Methods From January 2003 to August 2013, non-randomized 80 patients were treated with redo CABG in the Department of Cardiac Surgery, Peking University Third Hospital. Among these patients, 40 underwent on-pump CABG technique (redo-ONCAB group) and 40 underwent off-pump CABG technique (redo-OPCAB group). Furthermore, transmyocardial laser revascularization was performed in high-risk patients who were not suitable to conventional grafting. Clinical data of the two groups were recorded and analyzed including operation time, coronary grafts, incomplete revascularization, postoperative ventilation, perioperative stroke, and low output syndrome, etc. Results There were no significantly differences in age, gender distribution, incidences of hypertension, stroke, and other clinical characteristics between redo-OPCAB group and redo-ONCAB group (all P >0.05), except for incidences of renal dysfunction and pulmonary disease (all P P =0.0243). Compared with the redo-ONCAB group, there was shorter operation time ( P =0.0045), postoperative ventilation ( P =0.0211) and intensive care unit stay ( P =0.0400), as well as fewer use of platelet ( P =0.0338) and blood transfusion ( P =0.0034) in the redo-OPCAB group. The incidence of incomplete revascularization ( P =0.0253) and the use of transmyocardial laser revascularization ( P =0.0052) were higher in the redo-OPCAB group than those in the redo-ONCAB group (all P P >0.05). Conclusion Redo CABG is the safety and efficacy surgical procedure, and redo-OPCAB technique with better outcomes is commended especially in high-risk patients.