title: Free internal mammary artery graft reimplantation on the same vessel in repeat coronary revascularization.
abstract: We describe the case of a 62-year-old man who needed a 3-vessel coronary artery bypass reoperation and mitral valve replacement. The patient's existing free left internal mammary artery graft was not functioning because of a critical stenosis in the native vessel just after the distal anastomosis. The free graft itself was in perfect condition, and we decided to reuse it. Because the course of the graft was so tortuous, we concluded that skeletonization would yield the extra length needed for reimplantation. After reimplanting the graft, we performed venous grafting and mitral valve replacement. The patient was well and had no signs of ischemia at 29 months postoperatively. There have been few reports on recycling internal mammary artery grafts in repeat coronary artery bypass grafting. To our knowledge, ours is the first report of the reimplantation of a free internal mammary artery graft on the same vessel. We describe the procedure and our decision-making process.
authors: Mario
authors: M
authors: Vivirito
authors: Massimo
authors: M
authors: Conocchia
authors: Rosario
authors: R
authors: Patanè
authors: Ezio
authors: E
authors: Micalizzi
mesh_terms: D001705:Bioprosthesis; D001026:Coronary Artery Bypass / Q000379:methods*; D054059:Coronary Occlusion / Q000628:therapy; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000601:surgery; D009204:Myocardial Revascularization; D012086:Reoperation; D012092:Replantation / Q000379:methods*
keywords: Coronary artery bypass, off-pump/methods; coronary disease/surgery; equipment reuse; mammary arteries/transplantation; myocardial revascularization/methods; reoperation/methods; replantation/methods; thoracic arteries/transplantation; treatment outcome; vascular patency