Upgrading redo coronary artery bypass graft by recycling in situ arterial graft

We present a case of redo coronary artery bypass grafting (CABG) in which a single internal thoracic artery (ITA) graft was upgraded to a bilateral ITA graft by recycling a left ITA graft, anastomosed to the left anterior descending artery in primary CABG performed 17 years previously. During redo CABG, we dissected the left ITA, reused it in situ for the circumflex artery, and used the right ITA to the left anterior descending artery for a bilateral ITA graft. All grafts remained patent 2 years after redo CABG. Recycling ITA grafts may enable upgrading to bilateral ITA grafting during redo CABG.