Distribution and Results in Redo Cardiac Surgery

Oren Lev - Ran Cardiothoracic Surgery Department, Soroka Medical Univestity Center, Beer Sheva, Beer Sheva, Israel Menachem Matsa Cardiothoracic Surgery Department, Soroka Medical Univestity Center, Beer Sheva, Beer Sheva, Israel Shlomo Yaron Ishay Cardiothoracic Surgery Department, Soroka Medical Univestity Center, Beer Sheva, Beer Sheva, Israel Mahmud Abu Salah Cardiothoracic Surgery Department, Soroka Medical Univestity Center, Beer Sheva, Beer Sheva, Israel Leonid Ruderman Cardiothoracic Surgery Department, Soroka Medical Univestity Center, Beer Sheva, Beer Sheva, Israel Dan Abrhamov Cardiothoracic Surgery Department, Soroka Medical Univestity Center, Beer Sheva, Beer Sheva, Israel Gideon Sahar Cardiothoracic Surgery Department, Soroka Medical Univestity Center, Beer Sheva, Beer Sheva, Israel

Background: Redo cardiac surgery is associated with increased operative risk. We aimed to assess the distribution of operations and respective results.

Methods: The data of 154 patients undergoing repeat redo cardia surgery operated between 2006 and 2016 were analyzed. Patients were grouped according to type of surgery, coronary artery bypass grafting (CABG) or valve (s) replacement surgery (VR).

Results: Mean number of operation per year was 12.8 ± 0.6 (range 8-19). The distribution of isolated CABG after CABG, CABG after VR, VR after VR and VR after CABG was 18.2% (n=28), 4.5% (n=7), 49.4% (n=76) and 20.8% (n=32), respectively. In total, 51.9% and 48.1% of operations were performed after prior VR and prior CABG, respectively. Median time from prior operation was 8 ± 0.7 years (range, 1- 24). The observed-mortality 6.5% (10/154) compared favorably with the predicted 9% STS mortality. There was no difference in 30-day mortality between prior CABG versus prior VR (5.5% versus 7.5%, p=0.857). The respective 30-day mortality was 0%, 7.8 % and 6.2% for isolated CABG after CABG, VR after VR and VR after CABG, respectively. Among survivors, 10-year survival was 82% (Kaplan-Meier).

Conclusions: The type of prior surgery had no independent effect on the operative redo risk and prior CABG has not been delineated as independent correlate of early mortality. Redo cardiac surgery confers good late survival-outcome among survivors.