How to avoid problems in redo coronary artery bypass surgery.

The objective of my presentation is to discuss the various intra- and perioperative problems related to redo coronary artery bypass surgery so that we can minimize complications during surgery and improve the final outcomes. When a patient accepts redo cardiac surgery in spite of known higher morbidity and mortality, the patient strongly believes that he will come out of this operation successfully and enjoy several more years of life. Weintraub reported that redo cardiac surgery has higher mortality and morbidity; 5% in elective cases, 11% in urgent cases, and 16.4% in emergency cases. He and associates described that the female gender, a low ejection fraction (EF), and preoperative arrhythmias are significant risk factors. Lemmer and associates described poor postoperative functional results with the majority of patients having emergency repeat coronary artery revascularization developing recurrent ischemic syndrome within a short period of time. I am outlining the problems from our experience of 543 patients in the last five years.