Perioperative outcomes
Peripheral cannulation and cardiopulmonary bypass prior to re-sternotomy were instituted in 16% (group 1 - 17%, group 2 – 15%, p=0.73). Cardiovascular injury during re-sternotomy was recorded in 21 cases (12%). LIMA was the most commonly injured structure (6.2%) (Table 2). Mean cardiopulmonary bypass time was 140 ± 67 min (111 ± 47 min, group 1 and 169 ± 72 min, group 2, p<0.001). Mean cross clamp time was 74 ± 36 min (56 ± 20 min, group 1 and 93 ± 40 min, group 2, p<0.001) (Table 2).
In-hospital mortality was 7.8%, 5%, in group 1 versus 10.2%, in group 2, p=0.247 (Table 3). There was no difference in the composite outcome of perioperative complications (overall 19.1% (34/178), 14.4%, group 1 versus 23.8% group 2, p=0.110)
On multivariable analysis, NYHA class III-IV, perioperative IABP and cardiovascular injury to a mediastinal structure at re-sternotomy were independent predictors of in-hospital mortality (HR; 13.33, 95% CI; 2.04 to 83.33, p=0.007) (Table 4). COPD, LVEF<30% and perioperative IABP were predictors of a worse composite outcome of perioperative complications (Table 4).