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  • 1 Adana Numune Hospital, Adana, Turkey
  • 2 Baskent University, Adana, Turkey

Purpose

Redo cardiac operations represent one of the main challenges in heart surgery. The purpose of the study was to analyze the predictors of in-hospital mortality in patients undergoing reoperative cardiac surgery by a single surgical team.

Methods

A total of 1367 patients underwent cardiac surgical procedures and prospectively entered into a computerized database. Patients were divided into 2 groups based on the reoperative cardiac surgery (n = 109) and control group (n = 1258). Uni- and multivariate logistic regression analysis were performed to evaluate the possible predictors of hospital mortality.

Results

Mean age was 56 ± 13, and 46% were female in redo group. In-hospital mortality was 4.6 vs. 2.2%, p = 0.11. EuroSCORE (6 vs. 3; p > 0.01), cardiopulmonary bypass time (90 vs. 71 min; p > 0.01), postoperative bleeding (450 vs. 350 ml; p > 0.01), postoperative atrial fibrillation (AF) (29 vs. 16%; p > 0.01), and inotropic support (58 vs. 31%; p = 0.001) were significantly different. These variables were entered into uni- and multivariate regression analysis. Postoperative AF (OR 1.76, p = 0.007) and EuroSCORE (OR 1.42, p > 0.01) were significant risk factors predicting hospital mortality.

Conclusions

Reoperative cardiac surgery can be performed under similar risks as primary operations. Postoperative AF and EuroSCORE are predictors of in-hospital mortality for redo cases.

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  • 1.

    Keeling WB , Leshnower BG, Thourani VH, Kilgo PS, Chen EP: Outcomes following redo sternotomy for aortic surgery. Interact Cardiovasc Thorac Surg 15, 6368 (2012)

    • Search Google Scholar
    • Export Citation
  • 2.

    Di Mauro M , Iacò AL, Contini M, Teodori G, Vitolla G, Pano M, Di Giammarco G, Calafiore AM: Reoperative coronary artery bypass grafting: analysis of early and late outcomes. Ann Thorac Surg 79, 8187 (2005)

    • Search Google Scholar
    • Export Citation
  • 3.

    Kappetein AP , Feldman TE, Mack MJ, Morice MC, Holmes DR, Ståhle E, Dawkins KD, Mohr FW, Serruys PW, Colombo A: Comparison of coronary bypass surgery with drug-eluting stenting for the treatment of left main and/or three-vessel disease: 3-year follow-up of the SYNTAX trial. Eur Heart J 32, 21252134 (2011)

    • Search Google Scholar
    • Export Citation
  • 4.

    Head SJ , Mack MJ, Holmes DR Jr, Mohr FW, Morice MC, Serruys PW, Kappetein AP: Incidence, predictors and outcomes of incomplete revascularization after percutaneous coronary intervention and coronary artery bypass grafting: a subgroup analysis of 3-year SYNTAX data. Eur J Cardiothorac Surg 41, 535541 (2012)

    • Search Google Scholar
    • Export Citation
  • 5.

    Ngaage DL , Cowen ME, Griffin S, Guvendik L, Cale AR: The impact of symptom severity on cardiac reoperative risk: early referral and reoperation is warranted. Eur J Cardiothorac Surg 32, 623628 (2007)

    • Search Google Scholar
    • Export Citation
  • 6.

    LaPar DJ , Yang Z, Stukenborg GJ, Peeler BB, Kern JA, Kron IL, Ailawadi G: Outcomes of reoperative aortic valve replacement after previous sternotomy. J Thorac Cardiovasc Surg 139, 263272 (2010)

    • Search Google Scholar
    • Export Citation
  • 7.

    Park CB , Suri RM, Burkhart HM, Greason KL, Dearani JA, Schaff HV, Sundt TM 3rd: Identifying patients at particular risk of injury during repeat sternotomy: analysis of 2555 cardiac reoperations. J Thorac Cardiovasc Surg 140, 10281035 (2010)

    • Search Google Scholar
    • Export Citation
  • 8.

    Mills NL , Everson CT: Atherosclerosis of the ascending aorta and coronary artery bypass. Pathology, clinical correlates, and operative management. J Thorac Cardiovasc Surg 102, 546553 (1991)

    • Search Google Scholar
    • Export Citation
  • 9.

    Fukunaga N , Okada Y, Konishi Y, Murashita T, Kanemitsu H, Koyama T: Redo valvular surgery in elderly patients aged >75 years. J Heart Valve Dis 23, 228234 (2014)

    • Search Google Scholar
    • Export Citation
  • 10.

    Tekumit H , Cenal AR, Tataroglu C, Uzun K, Akinci E: Early outcomes of cardiac reoperations: seven years of experience. Turk J Thorac Cardiovasc Surg 17, 145150 (2009)

    • Search Google Scholar
    • Export Citation
  • 11.

    Balsam LB , Grossi EA, Greenhouse DG, Ursomanno P, Deanda A, Ribakove GH, Culliford AT, Galloway AC: Reoperative valve surgery in the elderly: predictors of risk and long-term survival. Ann Thorac Surg 90, 11952000 (2010)

    • Search Google Scholar
    • Export Citation
  • 12.

    Maganti M , Rao V, Armstrong S, Feindel CM, Scully HE, David TE: Redo valvular surgery in elderly patients. Ann Thorac Surg 87, 521525 (2009)

    • Search Google Scholar
    • Export Citation
  • 13.

    Roselli EE , Pettersson GB, Blackstone EH, Brizzio ME, Houghtaling PL, Hauck R, Burke JM, Lytle BW: Adverse events during reoperative cardiac surgery: frequency, characterization, and rescue. J Thorac Cardiovasc Surg 135, 316323 (2008)

    • Search Google Scholar
    • Export Citation
  • 14.

    de Almeida Brandão CM , Pomerantzeff PM, Souza LR, Tarasoutchi F, Grimberg M, Ramires JA, Almeida de Oliveira S: Multivariate analysis of risk factors for hospital mortality in valvular reoperations for prosthetic valve dysfunction. Eur J Cardiothorac Surg 22, 922926 (2002)

    • Search Google Scholar
    • Export Citation
  • 15.

    Parissis H , Leotsinidis M, Akbar MT, Apostolakis E, Dougenis D: The need for intra aortic balloon pump support following open heart surgery: risk analysis and outcome. J Cardiothorac Surg 5, 520 (2010)

    • Search Google Scholar
    • Export Citation
  • 16.

    Kobayashi KJ , Williams JA, Nwakanma LU, Weiss ES, Gott VL, Baumgartner WA, Conte JV: EuroSCORE predicts short- and mid-term mortality in combined aortic valve replacement and coronary artery bypass patients. J Card Surg 24, 637643 (2009)

    • Search Google Scholar
    • Export Citation
  • 17.

    Girerd N , Pibarot P, Daleau P, Voisine P, O’Hara G, Després JP, Mathieu P: Statins reduce short- and long-term mortality associated with postoperative atrial fibrillation after coronary artery bypass grafting: impact of postoperative atrial fibrillation and statin therapy on survival. Clin Cardiol 35, 430436 (2012)

    • Search Google Scholar
    • Export Citation

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