Minimally Invasive Redo Coronary Artery Bypass to Right Coronary Artery With Right Gastroepiploic Artery
Abel Cherian1, Alexander Ryan1, Yash Rohilla2
1College of Medicine-Tucson, University of Arizona, Tucson, Arizona.
Insights
Redo coronary artery bypass grafting (CABG) can be complex. A minimally invasive, sternotomy-sparing, off-pump redo CABG using a gastroepiploic artery graft was successfully performed in a patient with end-stage renal disease.
Area of Science:
- Cardiovascular Surgery
- Minimally Invasive Cardiac Surgery
- Interventional Cardiology
Background:
- Redo coronary artery bypass grafting (CABG) presents significant surgical challenges, including graft preservation and limited arterial graft options.
- Patients with prior CABG and comorbidities like end-stage renal disease require careful consideration for revascularization strategies.
Abstract:
Redo coronary artery bypass grafting (redo CABG) is a challenging procedure because surgical access must be reestablished, patent grafts must be preserved, and arterial graft selection is limited. We managed the case of a 58-year-old man with a history of prior CABG and end-stage renal disease in whom non-ST-segment elevation myocardial infarction developed as a result of severe in-stent restenosis of the mid right coronary artery. Coronary angiography demonstrated patent grafts, including left internal mammary to left anterior descending. To mitigate redo CABG risks, this patient underwent a sternotomy-sparing, off-pump, redo CABG by a gastroepiploic artery to posterior descending artery anastomosis through a minimally invasive subxiphoid approach.
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