Reoperative coronary artery bypass grafting via a left thoracotomy and a small laparotomy without cardiopulmonary bypass: report of a case.
A 66-year-old woman with aortic stenosis underwent an aortic root replacement with a composite graft and coronary artery reconstruction 2 years before presentation. On coronary angiography performed 2 years after operation, saphenous vein graft (SVG) to right coronary artery and SVG to first diagonal branch had both become totally occluded. SVG to left anterior descending artery showed 75% stenosis on the heel side of the distal anastomosis. The patient underwent a second coronary artery bypass via a left thoracotomy (the left internal thoracic artery was anastomosed to the first diagonal branch by interposing it with the left radial artery) and a small laparotomy (the right gastroepiploic artery was anastomosed to the right coronary artery) without a cardiopulmonary bypass. This approach is preferable to avoiding both a resternotomy and cardiopulmonary bypass in patients requiring repeat surgery.
Manabe
T
T
First Department of Surgery, Yokohama City University School of Medicine, Yokohama, Japan.
Tobe
M
M
Terada
M
M
Ichikawa
Y
Y
Uranaka
Y
Y
Yamazaki
I
I
Yano
Y
Y
Takanashi
Y
Y
D000368:Aged; D002315:Cardiopulmonary Bypass; D001026:Coronary Artery Bypass / Q000379:methods*; D005260:Female; D006801:Humans; D007813:Laparotomy; D011651:Pulmonary Artery / Q000601:surgery; D017534:Radial Artery / Q000637:transplantation; D012008:Recurrence; D012086:Reoperation; D012501:Saphenous Vein / Q000637:transplantation; D013908:Thoracotomy