Is the Visual Examination of LIMA Graft Sufficient for the Decision Reusing of This Graft in Redo Coronary Bypass Surgery?

Abstract

Listen

Translate article

Redo coronary artery bypass grafting (CABG) compromises a growing proportion of CABG in the current era of revascularization. Intimal hyperplasia at the site of anastomosis between left internal mammary artery (LIMA) and left anterior descending artery (LAD) is not infrequently reported causing severe ischemic symptoms in some patients. An additional grafting to distal LAD territory is a proper decision for the surgical strategy in most of the cases. Radial artery or venous grafts have been used for this purpose. Shortage of arterial grafts is the major concern in redo coronary surgery. Whether the previously anastomosed LIMA can be used is a major question in decision-making process. In this case report, we presented a complicated patient in whom LIMA was not reused although visual or angiographical examination was normal.