| Redo Coronary Revascularization
Using Off-Pump Axillo-Coronary Artery Bypass Grafting |
(Department of Thoracic and Cardiovascular Surgery,
Hokkaido Prefectural Kushiro Hospital, Kushiro, Japan and Department
of Thoracic and Cardiovascular Surgery, Sapporo Medical University
School of Medicine*, Sapporo, Japan)
| Yoshikazu Hachiro |
Hideyuki Harada |
Toshio Baba |
| Yukiko Honma |
Tomio Abe* |
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We describe two patients who underwent
repeat off-pump coronary revascularization by axillo-coronary
artery bypass grafting. A 63-year-old man (case 1), who had undergone
coronary artery bypass grafting (CABG) 13 years previously, was
admitted to our hospital with exertional angina. The saphenous
vein grafts (SVG) to the left anterior descending artery (LAD),
circumflex artery (Cx), and right coronary artery (RCA) all were
occluded. The left internal thoracic artery (LITA) also was occluded
because it had been injured. Because the patient declined to
undergo a redo CABG, percutaneous transluminal coronary angioplasty
(PTCA) to the LAD was attempted. However, coronary dissection
occurred, and an emergency operation was performed. A 66-year-old
man (case 2), who had undergone CABG 12 years previously, was
admitted with unstable angina. The LITA to the LAD and the SVG
to the RCA were occluded. The SVG to the Cx had 99% stenosis
in its mid-portion and was the cause of the angina. PTCA and
stenting of this SVG were performed. Two weeks later, an operation
was done. In both patients, the left axillary artery was selected
as the site of the proximal anastomosis. Both patients underwent
off-pump bypass grafting to the LAD from the left axillary artery
using a SVG. Both grafts were patent postoperatively. This approach
resulted in early symptomatic improvement.
Jpn. J. Cardiovasc. Surg. 32：175 -177 (2003) |
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