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Second Congress of Cardiology and Angiology of Bosnia & Herzegovina

 

REOPERATIONS IN ISCHAEMIC HEART DISEASE -OUR EXPERIANCES
S. Nastasić, R. Huskić, Z. Jocić, B. Đukanović, D. Nežić, S. Gradinac, A. Nikolić, M. Jakovljević, P. Milojević, M. Perić, S. Birovljev and M. Babić
Dedinje Cardiovascular Institute, Belgrade, Yugoslavia.

Aim: Analysis of 242 patients with REDO Aortocoronary bypass procedure (REDO ACB), who had been operated at Dedinje Cardiovascular Institute, Belgrade from January 1995 to August 31. 2000. The most important conditions for successful reoperation in ischaemic heart disease (IHD) are viability of myocardium and acceptable pathologic morphology on coronary arteries, which are still anatomically convenient for bypass procedure. In our 242 patients interval between the first ACB and REDO-ACB was 8,3 years. Most frequent reasons for REDO were evolution of occlusive changes on native coronary arteries and grafts, while pathologic changes on heart valves and aortic dissection were less frequent causes for REDO-ACB. Mutual finding in vast majority of almost every single patient was significantly higher ejection fraction (EF) in time of first ACB than REDO ACB. Operative technique was extracorporal circulation (ECC), only in 5 cases we operated patients on beating heart, while 3 operations were performed ion deep hypothermic circulatory arrest. Operative risk- mortality in REDO-ACB during 1995-1996 was 7,9%. As the number of REDO-ACB increased and our experience widened, we significantly decreased mortality rate to 4,4% in 1999 through 2000.
Conclusion: Operative risk in REDO-ACB in our experience is not considerably higher than in first ACB procedure, and we believe that with good selection, indications, experience, myocardial protection and operative technique these results may be further improved
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Drugi kongres kardiologa i angiologa Bosne i Hercegovine
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