{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T12:40:41Z","timestamp":1791463241934,"version":"4.3.4"},"reference-count":17,"publisher":"Georg Thieme Verlag KG","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Thorac Cardiovasc Surg"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Redo coronary artery bypass grafting (redo-CABG) is technically challenging and carries a higher perioperative risk than primary CABG. Whether avoiding cardiopulmonary bypass is beneficial in this setting remains unclear. We compared perioperative and long-term outcomes of off-pump versus on-pump redo-CABG in a high-volume center.<\/jats:p>\n                  <jats:p>All patients undergoing redo-CABG between 2009 and 2024 were retrospectively analyzed. Perioperative, in-hospital, and long-term outcomes were evaluated. Propensity score matching was performed using preoperative covariates. Survival analyses included a subgroup of beating-heart on-pump cases. Completeness of revascularization was likewise assessed.<\/jats:p>\n                  <jats:p>Among 370 patients (175 off-pump group; 195 on-pump group), 184 were propensity score-matched. Off-pump surgery had shorter operative time (183 vs. 208\u2009min; p\u2009=\u20090.015) and reduced red blood cell transfusion requirements (3 vs. 5 units; p\u2009=\u20090.014). Myocardial injury biomarkers were reduced with off-pump surgery (CK-MB: 45 vs. 68\u2009ng\/mL, p\u2009=\u20090.01; high-sensitivity troponin: 3,388 vs. 7,744\u2009ng\/L, p\u2009=\u20090.001). In-hospital mortality was comparable (off-pump group 2.2 vs. 1.1% in the on-pump group; p\u2009=\u20090.621; relative risk: 1.34). Rates of stroke, myocardial infarction, cardiopulmonary resuscitation, and hemofiltration did not differ. Five-year repeat revascularization rates were similar (off-pump group: 18.5 vs. 19.6% in the on-pump group; p\u2009=\u20090.854). Long-term survival did not differ between strategies. In multivariable analysis, surgical strategy (off-pump, on-pump, beating-heart) was not an independent predictor of survival.<\/jats:p>\n                  <jats:p>Off-pump redo-CABG is safe and yields outcomes similar to on-pump surgery. Pump strategy should be individualized based on patient's anatomy and surgical expertise.<\/jats:p>","DOI":"10.1055\/a-2900-0233","type":"journal-article","created":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T23:19:10Z","timestamp":1782170350000},"source":"Crossref","is-referenced-by-count":2,"title":["Long-Term Outcomes after Redo Coronary Artery Bypass Grafting: A Propensity-Matched Analysis of On-Pump and Off-Pump Techniques"],"prefix":"10.1055","author":[{"given":"Marcus-Andr\u00e9","family":"Deutsch","sequence":"first","affiliation":[{"name":"Heart and Diabetes Center North Rhine-Westphalia, Ruhr University Bochum, Germany","department":["Clinic for Cardiovascular and Thoracic Surgery"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-4678-3975","authenticated-orcid":false,"given":"Carl Thadd\u00e4us","family":"Braun","sequence":"additional","affiliation":[{"name":"Heart and Diabetes Center North Rhine-Westphalia, Ruhr University Bochum, Germany","department":["Clinic for Cardiovascular and Thoracic Surgery"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lena","family":"Steins","sequence":"additional","affiliation":[{"name":"Heart and Diabetes Center North Rhine-Westphalia, Ruhr University Bochum, Germany","department":["Clinic for Cardiovascular and Thoracic Surgery"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Malee Julie","family":"Scherer","sequence":"additional","affiliation":[{"name":"Heart and Diabetes Center North Rhine-Westphalia, Ruhr University Bochum, Germany","department":["Clinic for Cardiovascular and Thoracic Surgery"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dragan","family":"Opacic","sequence":"additional","affiliation":[{"name":"Heart and Diabetes Center North Rhine-Westphalia, Ruhr University Bochum, Germany","department":["Clinic for Cardiovascular and Thoracic Surgery"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George","family":"El-Hachem","sequence":"additional","affiliation":[{"name":"Heart and Diabetes Center North Rhine-Westphalia, Ruhr University Bochum, Germany","department":["Clinic for Cardiovascular and Thoracic Surgery"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9505-1358","authenticated-orcid":false,"given":"Sebastian V.","family":"Rojas","sequence":"additional","affiliation":[{"name":"Heart and Diabetes Center North Rhine-Westphalia, Ruhr University Bochum, Germany","department":["Clinic for Cardiovascular and Thoracic Surgery"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammad","family":"Sharaf","sequence":"additional","affiliation":[{"name":"Heart and Diabetes Center North Rhine-Westphalia, Ruhr University Bochum, Germany","department":["Clinic for Cardiovascular and Thoracic Surgery"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan Fritz","family":"Gummert","sequence":"additional","affiliation":[{"name":"Heart and Diabetes Center North Rhine-Westphalia, Ruhr University Bochum, Germany","department":["Clinic for Cardiovascular and Thoracic Surgery"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Darko","family":"Radakovic","sequence":"additional","affiliation":[{"name":"Heart and Diabetes Center North Rhine-Westphalia, Ruhr University Bochum, Germany","department":["Clinic for Cardiovascular and Thoracic Surgery"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2026,7,3]]},"reference":[{"issue":"03","key":"ref1","doi-asserted-by":"crossref","first-page":"225","DOI":"10.5090\/kjtcs.2014.47.3.225","article-title":"Early and midterm outcome of redo coronary artery bypass grafting: on-pump versus off-pump bypass","volume":"47","author":"Y R Shin","year":"2014","journal-title":"Korean J Thorac Cardiovasc Surg"},{"issue":"02","key":"ref2","doi-asserted-by":"crossref","first-page":"447","DOI":"10.1016\/j.jtcvs.2019.03.122","article-title":"Off-pump versus on-pump redo coronary artery bypass grafting: a propensity score analysis of long-term follow-up","volume":"159","author":"M I Rufa","year":"2020","journal-title":"J Thorac Cardiovasc Surg"},{"issue":"05","key":"ref3","doi-asserted-by":"crossref","first-page":"945","DOI":"10.1093\/ejcts\/ezx137","article-title":"Early health outcome and 10-year survival in patients undergoing redo coronary surgery with or without cardiopulmonary bypass: a propensity score-matched analysis","volume":"52","author":"V D Bruno","year":"2017","journal-title":"Eur J Cardiothorac Surg"},{"issue":"12","key":"ref4","doi-asserted-by":"crossref","first-page":"4497","DOI":"10.1111\/jocs.15986","article-title":"Complete surgical revascularization: different definitions, same 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Med"},{"issue":"03","key":"ref8","doi-asserted-by":"crossref","first-page":"527","DOI":"10.1016\/j.jtcvs.2007.10.019","article-title":"Ten-year experience with single-vessel and multivessel reoperative off-pump coronary artery bypass grafting","volume":"135","author":"Y K Mishra","year":"2008","journal-title":"J Thorac Cardiovasc Surg"},{"issue":"02","key":"ref9","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1007\/s00392-006-0335-5","article-title":"Coronary reoperation with and without cardiopulmonary bypass","volume":"95","author":"S M Tugtekin","year":"2006","journal-title":"Clin Res Cardiol"},{"key":"ref10","doi-asserted-by":"crossref","first-page":"869987","DOI":"10.3389\/fcvm.2022.869987","article-title":"A meta-analysis of early, mid-term and long-term mortality of on-pump vs. off-pump in redo coronary artery bypass surgery","volume":"9","author":"S Zhang","year":"2022","journal-title":"Front Cardiovasc Med"},{"issue":"02","key":"ref11","doi-asserted-by":"crossref","first-page":"209","DOI":"10.1016\/j.ejcts.2007.11.011","article-title":"Propensity score analysis of early and late outcome after redo off-pump and on-pump coronary artery bypass grafting","volume":"33","author":"H A Vohra","year":"2008","journal-title":"Eur J Cardiothorac Surg"},{"issue":"01","key":"ref12","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1016\/j.athoracsur.2004.06.058","article-title":"Reoperative coronary artery bypass grafting: analysis of early and late outcomes","volume":"79","author":"M Di Mauro","year":"2005","journal-title":"Ann Thorac Surg"},{"issue":"03","key":"ref13","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1056\/NEJMoa0807611","article-title":"Fractional flow reserve versus angiography for guiding percutaneous coronary intervention","volume":"360","author":"P AL Tonino","year":"2009","journal-title":"N Engl J Med"},{"issue":"09","key":"ref14","doi-asserted-by":"crossref","first-page":"1281","DOI":"10.1016\/j.hlc.2021.02.015","article-title":"Repeat coronary artery bypass grafting: a meta-analysis of off-pump versus on-pump techniques in a large cohort of patients","volume":"30","author":"A Tzoumas","year":"2021","journal-title":"Heart Lung Circ"},{"issue":"04","key":"ref15","first-page":"398","article-title":"Off versus on pump myocardial revascularization in patients with severe asymptomatic carotid stenosis","volume":"65","author":"D Opacic","year":"2024","journal-title":"J Cardiovasc Surg (Torino)"},{"issue":"01","key":"ref16","doi-asserted-by":"crossref","first-page":"235","DOI":"10.1016\/j.jtcvs.2016.02.047","article-title":"Postoperative acute kidney injury defined by RIFLE criteria predicts early health outcome and long-term survival in patients undergoing redo coronary artery bypass graft surgery","volume":"152","author":"M Zakkar","year":"2016","journal-title":"J Thorac Cardiovasc Surg"},{"issue":"10","key":"ref17","doi-asserted-by":"crossref","first-page":"1873","DOI":"10.1007\/s00134-004-2388-0","article-title":"Coagulation disorders of cardiopulmonary bypass: a review","volume":"30","author":"D Paparella","year":"2004","journal-title":"Intensive Care Med"}],"container-title":["The Thoracic and Cardiovascular Surgeon"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2900-0233.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,4]],"date-time":"2026-07-04T00:12:11Z","timestamp":1783123931000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2900-0233"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,22]]},"references-count":17,"URL":"https:\/\/doi.org\/10.1055\/a-2900-0233","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0171-6425","1439-1902"],"issn-type":[{"value":"0171-6425","type":"print"},{"value":"1439-1902","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,6,22]]},"published":{"date-parts":[[2026,6,22]]}}}