Abstract
To describe patient selection criteria, surgical technique and early outcomes in patients undergoing reoperative coronary artery bypass surgery (RECABG) through a left thoracotomy without cardiopulmonary bypass (CPB). Eight patients with patent grafts to the anterior interventricular branch of left coronary artery (four of which had also patent grafts to the right coronary artery) requiring revascularization of the circumflex coronary system had redo-CABG without CPB through a left posterolateral thoracotomy. There was no in-hospital mortality or serious postoperative complications. All patients are angina-free. An off-pump redo-CABG through a left posterolateral thoracotomy may reduce risks attributable to resternotomy in patients who met the selection criteria.
Highlights
The outcomes of reoperative coronary artery bypass grafting have been improved along the years [1], some clinical situations, such as the internal thoracic artery grafts, carry a higher risk during resternotomy
In 1982, Cheung et al; [2] and Faro et al [3] independently described the experience in performing left thoracotomy for circumflex coronary artery revascularization in patients who had undergone previous cardiac surgery
The choice of the technique was due to the presence of the patent grafts, especially the internal thoracic artery grafting to the anterior interventricular branch of left coronary artery, and the need to revascularize the circumflex branch of left coronary artery
Summary
The outcomes of reoperative coronary artery bypass grafting have been improved along the years [1], some clinical situations, such as the internal thoracic artery grafts, carry a higher risk during resternotomy. In 1982, Cheung et al; [2] and Faro et al [3] independently described the experience in performing left thoracotomy for circumflex coronary artery revascularization in patients who had undergone previous cardiac surgery. The use of left thoracotomy for myocardial revascularization, besides to have been proven as a simple technique, has been sporadically reported [4,5,6,7,8,9,10,11,12,13,14,15]. Our first experience was with a patient who required coronary artery bypass grafting concomitant with an aortic coarctation [16]. The aim of the present study is to attract attention upon to this technical option of coronary surgery
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