Urgent reoperation early after coronary artery bypass graft
10.3760/cma.j.issn.1001-4497.2011.03.012
- VernacularTitle:冠状动脉旁路移植术后早期紧急再次手术
- Author:
Huaijun ZHANG
;
Yunhu SONG
;
Jianping XU
;
Wei FENG
;
Shengshou HU
- Publication Type:Journal Article
- Keywords:
Coronary artery bypass;
Myocardial ischemia;
Reoperation
- From:
Chinese Journal of Thoracic and Cardiovascular Surgery
2011;27(3):168-169,161
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the cause of acute myocardial ischemia early after coronary artery bapass graft (CABG) and surgical management on it. Methods From 2001 to 2009, 28 patients underwent urgent reoperation early after CABG due to acute myocardial ischemia. The incidence of reoperation is about 0.02%. The cause of reoperation inclouded early graft occlusion (10 cases) ,IMA damage or injury during harvesting(9 cases), inexactitude distal anastomosis(2 cases)and radial artery spasm(4 cases). The mean interval time between two operations was 8 hours. Reoperation was done under offpump bypass in 2 patients and on-bypass used in other patients. Unsatisfactoey graft were substituted with new graft material and thrombotic was removed. If LIMA was the reson for myocardial ischemia, an additional vein graft was inserted. The spasm radial artery were substituted with new vein graft. Completely revascularization was used in re-do CABG. Results Two patients died during reoperation. 8 patients was died between 1 day and 14 days after reoperation. IABP was used in 16 patients,which 2 patients received ECMO suppord and 2 patient received LVAD suppord at mean time. Conclusion There have very high mortality in acute myocardial ischemia early after CABG. The early diagnosis and correct surgical management can improve the rates of survival. The active prevent should be emphasized during the first CABG.
