DEPARTMENT OF CARDIOTHORACIC SURGERY, MADANI HEART HOSPITAL, TABRIZ, IRAN
Background: Heart diseases, among them chronic atherosclerotic disease, are recognized as the most prevalent reasons of death in most countries, especially in Iran. For almost half a century now, coronary artery bypass graft surgery (CABG) has helped the medical community combat this disease. However, a considerable number of patients will require repeat grafting (redo surgery) after a variable period of time. The aim of this research was to study redo CABG surgery clinically in patients admitted to a major referral center in Tehran.
Methods: This retrospective and descriptive study was carried out in light of the medical records of 72 patients who had undergone redo CABG in our department between 1999 and 2002. Patient information was collected via questionnaires concerning demographic data, risk factors, indications for redo operation, ejection fraction, mortality, morbidity and events after redo operation. A statistical analysis, based on the SPSS software, was carried out through a descriptive statistical method.
Results: Among the significant findings of this study were a prevalence of 1.72% for redo CABG; reduction in EF (ejection fraction) between the two operations; stable angina as the most prevalent clinical sign; elevation of risk factors such as diabetes, hypertension and hyperlipidemia; short time intervals between the two operations in our country in comparison to the other fully accredited centers abroad; increase in preoperative morbidity; and considerable increase in atherosclerosis in native vessels and implanted grafts.
Conclusion: On account of the increase in morbidity and life expectancy of patients, it is suggested that special centers undertake necessary training required to perform redo CABG. The fact that more comprehensive studies are required and that the number of redo CABG is bound to increase necessitates the establishment of more self-sufficient hospitals.