PMID- 11432471
OWN - NLM
STAT- MEDLINE
DCOM- 20011101
LR  - 20161124
IS  - 0171-6425 (Print)
IS  - 0171-6425 (Linking)
VI  - 49
IP  - 3
DP  - 2001 Jun
TI  - Re-OPCAB vs. Re-CABG for myocardial revascularization.
PG  - 144-8
AB  - BACKGROUND: The present study compared redo coronary artery bypass grafting 
      (Re-OPCAB) techniques with conventional redo coronary artery bypass grafting 
      (Re-CABG) with particular focus on myocardial damage and clinical outcome 
      parameters. METHODS: Redo OPCAB (Re-OPCAB) was performed on 20 consecutive 
      patients (15 males, mean age 63.2 +/- 9.3 years) using either the anterolateral 
      approach for minimally invasive direct coronary artery bypass (n = 4) or the 
      Octopus technique with regular sternotomy (n = 16). The Re-CABG group consisted 
      of 20 consecutive patients (18 males, mean age 67.1 +/- 6.6 years). Groups did 
      not differ in the number of atherosclerotic risk factors, or left ventricular, 
      renal or liver function. RESULTS: Duration of surgery, number of bypass grafts 
      and amount of transfused red blood cells did not differ significantly between 
      both groups. Requirement of epinephrine (mg/h) within the first 24 h was lower in 
      the Re-OPCAB group (Re-OPCAB: 0.14 +/- 0.22 vs. CABG: 0.88 +/- 0.97; p<0.01). In 
      addition, CKMB levels at 24 h after operation were lower in the Re-OPCAB group 
      (Re-OPCAB: 10.0 +/- 10.1 vs. Re-CABG: 38.7 +/- 28.1 U/l, p<0.001). There were no 
      acute myocardial infarctions or deaths in the perioperative period. In the CABG 
      group, there was a longer time period to extubation (hours) (Re-OPCAB: 9.8 +/- 
      3.9 vs. Re-CABG: 28.7 +/- 25.5; p<0.001), and the length of ICU stay was 
      significantly prolonged (OPCAB: 1.3 +/- 0.5 versus Re-CABG: 4.4 +/- 8.7; 
      p<0.001). The graft patency rate at follow-up was 95% in the Re-OPCAB group. 
      CONCLUSION: Re-OPCAB results in decreased cardiac specific enzyme release, 
      reduced requirement of inotropes and comparable clinical outcome in the early 
      postoperative period. It is an appropriate alternative to conventional Re-CABG in 
      selected patients awaiting reoperation for myocardial revascularization. Larger 
      prospective and randomized trials are required to select the appropriate patient 
      who benefits most from one or the other treatment regime.
FAU - Schutz, A
AU  - Schutz A
AD  - Department of Cardiac Surgery, Herzklinik am Augustinum, Munchen, Germany. 
      a.schuetz@hch.med.uni-muenchen.de
FAU - Mair, H
AU  - Mair H
FAU - Wildhirt, S M
AU  - Wildhirt SM
FAU - Gillrath, G
AU  - Gillrath G
FAU - Lamm, P
AU  - Lamm P
FAU - Kilger, E
AU  - Kilger E
FAU - Reichart, B
AU  - Reichart B
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - Germany
TA  - Thorac Cardiovasc Surg
JT  - The Thoracic and cardiovascular surgeon
JID - 7903387
RN  - 0 (Isoenzymes)
RN  - EC 2.7.3.2 (Creatine Kinase)
RN  - EC 2.7.3.2 (Creatine Kinase, MB Form)
SB  - IM
MH  - Aged
MH  - Angiography
MH  - *Coronary Artery Bypass
MH  - Coronary Disease/diagnostic imaging/mortality/*surgery
MH  - Creatine Kinase/metabolism
MH  - Creatine Kinase, MB Form
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Isoenzymes/metabolism
MH  - Length of Stay
MH  - Male
MH  - Middle Aged
MH  - *Myocardial Revascularization
MH  - Reoperation
MH  - Time Factors
MH  - Treatment Outcome
MH  - Vascular Patency/physiology
EDAT- 2001/07/04 10:00
MHDA- 2001/11/03 10:01
CRDT- 2001/07/04 10:00
PHST- 2001/07/04 10:00 [pubmed]
PHST- 2001/11/03 10:01 [medline]
PHST- 2001/07/04 10:00 [entrez]
AID - 10.1055/s-2001-14290 [doi]
PST - ppublish
SO  - Thorac Cardiovasc Surg. 2001 Jun;49(3):144-8. doi: 10.1055/s-2001-14290.