Abstract
Redo Aortic valve replacement after previous Coronary Artery Bypass Grafting (CABG) in patients with patent internal mammary pedicled grafts poses a high risk because of the dual nature of the underlying ischaemia and valvular heart disease. The surgery is challenging because of the extensive internal mammary artery (IMA) dissection required which can result in a small but significant risk to injury to the graft resulting in high mortality. Various techniques are now being described to perform such high risk surgeries without IMA dissection. We report two cases who had undergone CABG with Left internal mammary artery (LIMA) to Left anterior descending artery (LAD) as one of the grafts presented subsequently for aortic valve repair (AVR) for calcific aortic stenosis.
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