title: Axillary-coronary artery bypass reconstruction as an alternative in coronary artery reoperations.
abstract: OBJECTIVE
  The increasing incidence of reoperations in coronary surgery associated with higher perioperative risks is a challenge for refinement of the surgical methods. The aim of the work is to prove the feasibility and satisfactory intermediate results of minimally invasive axillary-coronary artery bypass reconstruction in redo coronary surgery in case the left internal mammary artery had already been harvested.
  
  
  METHODS
  Three patients (six months, two and six years after primary coronary artery bypass grafting) admitted for redo coronary surgery because of a recurrence of angina and proven malfunction of the left internal mammary artery-left anterior descending coronary artery anastomosis. An axillary-coronary venous graft was performed via left anterior small thoracotomy (LAST) on a beating heart in all three cases.
  
  
  RESULTS
  Excellent patency of the graft was noted on control angiography within 9 days after the procedure together with good clinical improvement in midterm follow-up.
  
  
  CONCLUSIONS
  Minimally invasive axillary-coronary artery bypass via LAST access in redo coronary surgery is a good alternative in cases where the left internal mammary artery cannot be used.
authors.affiliation: Department of Cardiac Surgery, Charles University Hospital-Hradec Kralove, Czech Republic. jharrer@seznam.cz
authors.forename: J
authors.initials: J
authors.lastname: Harrer
authors.forename: J
authors.initials: J
authors.lastname: Dominik
authors.forename: P
authors.initials: P
authors.lastname: Zácek
authors.forename: I
authors.initials: I
authors.lastname: Varvarovský
mesh_terms: D000368:Aged; D001366:Axillary Artery / Q000601:surgery*; D001026:Coronary Artery Bypass / Q000379:methods*; D005240:Feasibility Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D012086:Reoperation