BACKGROUND
Redo cardiac surgery represents 5–8% of the current surgical practice [1–4]. In particular, reoperative coronary artery bypass grafting (redo-CABG) remains challenging [1–4] with prolonged operation time, bleeding, poor access to coronary targets and risk of coronary microembolization leading to complications [2, 3]. Redo-CABG has declined over the last decade to 2.5–4% of all coronary procedures, probably due to improved platelet inhibition [2, 3], use of more arterial conduits or to the use of percutaneous coronary intervention stenting to treat occluded grafts or new stenosis [5]. Poor risk profile in these patients may trigger complications associated with prolonged cardiopulmonary bypass and cardioplegic arrest time [6]. Studies from North America, Japan and India have highlighted the use of off-pump CABG as an alternative to redo coronary surgery (redo-OPCAB) [1, 6, 7]. However, most of these studies are based on small patient cohorts, and none of these studies has evaluated the impact of redo-OPCAB on long-term survival. In this study, we assess the safety and efficacy of redo-OPCAB versus redo-CABG using a combined end-point of serious postoperative complications as well as 1-, 5-, and 10-year survival.