What are the Predictors that Affect the Excellent Long-term Benefits of Redo Coronary Artery Bypass Grafting?

Outcomes of Reoperative Coronary Artery Bypass Graft Surgery in the United States

Background

There is a paucity of data on the trends and outcomes of reoperative coronary artery bypass graft (CABG) surgery during the current decade in the United States.

Methods and Results

We queried the National Inpatient Sample database (2002–2016) for all hospitalizations with isolated CABG procedure. We reported the temporal trends and outcomes of reoperative CABG versus primary CABG procedures. The main outcome was in‐hospital mortality. Among 3 212 768 hospitalizations with CABG, 46 820 (1.5%) had reoperative CABG. Over the 15‐year study period, there were no changes in the proportion of reoperative CABG (1.8% in 2002 versus 2.2% in 2016, P_tren=0.08), and the related in‐hospital mortality (3.7% in 2002 versus 2.7% in 2016, P_trend=0.97). Reoperative CABG was performed in patients with increasingly higher risk profile. Compared with primary CABG, hospitalizations for reoperative CABG were associated with higher in‐hospital mortality (3.2% versus 1.9%, P<0.001), cardiac arrest, cardiogenic shock, vascular complications, and respiratory complications. Among hospitalizations for reoperative CABG, the predictors of higher mortality included history of heart failure and chronic kidney disease.

Conclusions

In this 15‐year nationwide analysis, reoperative CABG procedures were increasingly performed in patients with higher risk profile. In‐hospital mortality rates were relatively low and did not change during the examined period. Compared with primary CABG, reoperative CABG is associated with higher in‐hospital mortality.