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Surgical Swine Model of Chronic Cardiac Ischemia Treated by Off-Pump Coronary Artery Bypass Graft Surgery
Published on: March 27, 2018
[Evaluation of early results of re-coronary artery bypass grafting]
Masamichi Ito1, M Takahira, Y Kamikubo
1Department of Cardiovascular Surgery, Kushiro City General Hospital, Japan.
Insights
Redo coronary artery bypass grafting (re-CABG) is feasible with low risk. Utilizing varied surgical approaches in re-CABG can prevent injury from adhesions, ensuring graft patency.
Area of Science:
- Cardiovascular Surgery
- Thoracic Surgery
Context:
- Redo coronary artery bypass grafting (re-CABG) presents unique challenges compared to primary operations.
- Adhesions from previous surgeries increase dissection risks.
Purpose:
- To evaluate the safety and feasibility of re-coronary artery bypass grafting (re-CABG).
- To assess the utility of employing different surgical approaches in redo CABG procedures.
Summary:
- Nineteen patients underwent re-CABG between 2002 and 2008.
- Various surgical approaches were utilized, including median re-sternotomy, left posterolateral thoracotomy, via diaphragm, and left anterior small thoracotomy (LAST).
- Eleven of sixteen simple CABG patients (68.8%) had a different approach than their primary operation, with femoral vessels exposed prior to sternotomy. No adverse events or operative deaths occurred, and all grafts remained patent.
Impact:
- Redo CABG can be performed safely with a low risk of complications.
- Adapting surgical strategies for redo CABG is crucial for minimizing operative risks and ensuring successful outcomes.
Abstract:
Redo surgery is more difficult than primary operation. From January 2002 to December 2008, 19 patients underwent re-coronary artery bypass grafting (re-CABG) [6.4 percent of the total CABG] : CABG (16) and CABG + combined procedure (3). Approach of redo operation consists of, median re-sternotomy (5), left posterolatelal thoracotomy (4), via diaphragm (6) and left anterior small thoracotomy (LAST) [1]. In a redo operation, we consider different approaches from the primary operation to avoid injury during dissection of adhesive tissue. Particularly in simple CABG, 11 of the 16 patients (68.8%) were operated on adopting a different approach from the primary operation. The femoral artery and vein were exposed before median re-sternotomy. There was no serious adverse event nor operative death, and all grafts were well patent. Redo CABG can be performed with a low risk.
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