Re-use of left internal thoracic artery for redo operation after MIDCAB

We report a case of recycling of left internal thoracic artery (LITA) in situ in reoperation of coronary artery bypass grafting. A 41-year-old male, who has poor-controlled hypercholesterolemia, was bypassed LITA to the left anterior descending artery (LAD) in minimally invasive direct coronary artery bypass (MIDCAB) manner at the other hospital. Four months later, he felt short of breath on effort. Coronary angiogram showed stenoses of the left main trunk and anastomosis site of the LITA. At redo operation, we skeletonised the LITA and reused it in situ to the LAD. Using the skeletonised method for re-harvesting LITA made the graft reach a more distal portion without tension. He is doing well at 18 months after surgery. In selected patients, recycling of the used arterial grafts can reserve other arterial grafts for redo operations in the future.