Re-coronary artery bypass grafting using a MIDCAB technique in a patient with a patent RITA-LAD graft
Naito, H.; Kawata, T.; Mizuguchi, K.; Nishioka, H.; Kameda, Y.; Sakaguchi, H.; Yasukawa, M.; Nezu, K.; Taniguchi, S.
Kyobu Geka. Japanese Journal of Thoracic Surgery 52(12): 1025-1028
1999
ISSN/ISBN: 0021-5252 PMID: 10554490 Document Number: 504827
In a patient with a patent RITA-LAD (right internal thoracic artery-left anterior descending artery) graft, re-CABG (re-coronary artery bypass grafting) with re-median sternotomy has been a high risk procedure. A 56-year-old male underwent 4-CABG (RITA-LAD, LITA-Dx, SVG-PL, and SVG-RCA) nine years ago. Coronary angiography showed that the RITA-LAD graft was well patent, but there was 95% stenosis distal to RITA-LAD anastomosis site. We performed re-CABG (right gastroepiploic artery-LAD; RGEA-LAD), using MIDCAB (minimally invasive direct coronary artery bypass) technique with neither re-median sternotomy nor cardiopulmonary bypass. The right gastroepiploic artery was harvested through a small upper median laparotomy and anastomosed to LAD through a small left anterior thoracotomy. The postoperative course was uneventful. This technique seems to be useful for re-revascularization of the LAD in a patient with a patent RITA-LAD graft.