Brazilian journal of cardiovascular surgery
Outcomes and Challenges of Redo Coronary Artery Bypass Grafting: A Propensity-Matched Comparative Analysis
By Arnaz A, Mahmudov V and Yalcinbas YK.
Abstract
Introduction
This study aims to compare the perioperative and long-term outcomes of reoperative coronary artery bypass grafting (CABG) with primary CABG in a propensity score-matched patient cohort.
Methods
We retrospectively analyzed 2,021 patients who underwent CABG between January 2003 and January 2024. Among them, 35 (1.7%) patients underwent redo CABG. Using 1:1 propensity score matching based on age, ejection fraction, diabetes mellitus, and hypertension, 36 patients who underwent primary CABG were selected for comparison. Patients with incomplete records or combined cardiac procedures were excluded. Perioperative variables, in-hospital mortality, and long-term survival were analyzed.
Results
The redo CABG group had significantly longer intensive care unit stays (2.15 ± 2.37 vs. 1.39 ± 1.36 days, P = 0.006), hospital stays (12.11 ± 17.40 vs. 7.36 ± 2.21 days, P = 0.009), and postoperative bleeding (899.12 ± 445.17 vs. 576.39 ± 323.92 ml, P = 0.001). Hospital mortality occurred in two patients (5.7%) in the redo group and one patient (2.8%) in the primary group (P = 0.614). Kaplan-Meier survival analysis showed higher long-term survival in the redo CABG group (77.1%) compared to the primary CABG group (58.3%), though not statistically significant (P = 0.168).