Management of patent saphenous vein grafts during reoperative coronary artery bypass grafting

Abstract

A patient was referred for coronary artery bypass reoperation. After a left internal mammary artery was grafted to the left anterior descending coronary artery, the diseased but patent old saphenous vein graft was ligated. This resulted in severe myocardial failure, which was corrected only after restoration of flow through the old vein graft. We suggest the decision to ligate or replace an old vein graft should be individualized to avoid the risk of myocardial ischemia.