Repeat coronary artery bypass in a patient with liver cirrhosis

Area of Science:

• Cardiovascular Surgery
• Thoracic Surgery
• Cardiac Anesthesia

Background:

• A 69-year-old male patient presented with comorbidities including liver cirrhosis and thrombocytopenia.
• The patient had a history of previous coronary artery bypass grafting (CABG) and presented with unstable angina.

Observation:

• The patient underwent a repeat CABG procedure.
• The surgery was performed using a lateral thoracotomy approach.
• The procedure was conducted on a beating heart, without the need for extracorporeal circulatory support.

Findings:

• Successful repeat coronary artery bypass grafting (CABG) was achieved.
• The beating heart technique was feasible and effective in this complex patient.
• Minimally invasive approach via lateral thoracotomy was utilized.

Implications:

• This case demonstrates the feasibility of repeat CABG in high-risk patients with significant comorbidities.
• Beating heart surgery without cardiopulmonary bypass may offer advantages in select patient populations.
• Lateral thoracotomy provides an alternative surgical approach for complex cardiac reoperations.