Reoperation for bleeding following coronary artery bypass surgery with special focus on long-term outcomes.
Cast your vote
You can rate an item by clicking the amount of stars they wish to award to this item.
When enough users have cast their vote on this item, the average rating will also be shown.
Your vote was cast
Thank you for your feedback
Thank you for your feedback
AuthorsMarteinsson, Steinthor A
Heimisdóttir, Alexandra A
Axelsson, Tomas A
Arnadottir, Linda O
Gardarsdottir, Helga R
Sigurdsson, Martin I
MetadataShow full item record
CitationMarteinsson SA, Heimisdóttir AA, Axelsson TA, et al. Reoperation for bleeding following coronary artery bypass surgery with special focus on long-term outcomes [published online ahead of print, 2020 Apr 30]. Scand Cardiovasc J. 2020;1-9. doi:10.1080/14017431.2020.1751265
AbstractObjectives: We studied the incidence and risk factors of reoperation for bleeding following CABG in a nationwide cohort with focus on long-term complications and survival. Design: A retrospective study on 2060 consecutive, isolated CABG patients operated 2001-2016. Outcome of reoperated patients (n = 130) were compared to non-reoperated ones (n = 1930), including major adverse cardiac and cerebrovascular events (MACCE) and overall survival. Risk factors for reoperation were determined using multivariate logistic regression and a Cox proportional hazards model to assess prognostic factors of long-term survival. Median follow-up was 7.6 years. Results: One hundred thirty patients (6.3%) were reoperated with an annual decrease of 4.1% per year over the study period (p=.04). Major complications (18.5 vs. 9.6%) and 30-day mortality (8.5 vs. 1.9%,) were higher in the reoperation group (p<.001). The use of clopidogrel preoperatively (OR 3.62, 95% CI: 1.90-6.57) and reduced left ventricular ejection fraction (OR 2.23, 95% CI: 1.25-3.77) were the strongest predictors of reoperation, whereas off-pump surgery was associated with a lower reoperation risk (OR 0.44, 95% CI: 0.22-0.85). After exluding patients that died within 30 days postoperatively, no difference in long-term survival or freedom from MACCE was found between groups, and reoperation was not an independent risk factor for long-term mortality in multivariate analysis. Conclusions: The reoperation rate in this study was relatively high but decreased significantly over time. Reoperation was associated with twofold increased risk for major complications and fourfold 30-day mortality, but comparable long-term MACCE and survival rates. This implies that if patients survive the first 30 days following reoperation, their long-term outcome is comparable to non-reoperated patients.
DescriptionTo access publisher's full text version of this article click on the hyperlink below
- [Comparison on the long-term outcomes post percutaneous coronary intervention or coronary artery bypass grafting for bifurcation lesions in unprotected left main coronary artery].
- Authors: Yang BG, Yu XP, Chen F, Lyu SZ, Li Q, He JQ, Yuan F
- Issue date: 2017 Jan 25
- [No significant association between obesity and long-term outcome of coronary artery bypass grafting].
- Authors: Thorkelsdottir T, Johannesdottir H, Arnadottir LO, Adalsteinsson J, Gardarsdottir HR, Helgason D, Axelsson TA, Helgadottir S, Heimisdottir AA, Sigurdsson MI, Gudbjartsson T
- Issue date: 2019 Juli
- Favourable long-term outcome after coronary artery bypass grafting in a nationwide cohort.
- Authors: Johannesdottir H, Arnadottir LO, Adalsteinsson JA, Axelsson TA, Sigurdsson MI, Helgadottir S, Helgason D, Gardarsdottir HR, Marteinsson SA, Geirsson A, Thorgeirsson G, Gudbjartsson T
- Issue date: 2017 Dec
- Three-year follow-up in a subset of high-risk patients randomly assigned to off-pump versus on-pump coronary artery bypass surgery: the Best Bypass Surgery trial.
- Authors: Møller CH, Perko MJ, Lund JT, Andersen LW, Kelbæk H, Madsen JK, Winkel P, Gluud C, Steinbrüchel DA
- Issue date: 2011 Jun
- A comparison of short- and long-term outcomes after off-pump and on-pump coronary artery bypass graft surgery with sternotomy.
- Authors: Racz MJ, Hannan EL, Isom OW, Subramanian VA, Jones RH, Gold JP, Ryan TJ, Hartman A, Culliford AT, Bennett E, Lancey RA, Rose EA
- Issue date: 2004 Feb 18