[Two cases of reoperative coronary bypass grafting through a small left thoracotomy]

Abstract

A reoperation by a MIDCAB (minimally invasive direct coronary artery bypass) was performed on 2 patients, including one who had undergone a surgical repair of a left ventricular rupture and another who had undergone a coronary artery bypass operation. In both patients, the left internal thoracic artery was isolated by a left small thoracotomy and then was anastomosed to the LAD (left anterior descending artery). One patient showed stenosis at the site of anastomosis and thus required coronary arterioplasty postoperatively, but was discharged without any further complications. When performing a reoperation by MIDCAB, complications such as injuries to the heart and patent graft during surgery and postoperative complications can be minimized by only performing a bypass to LAD. Such a bypass is usually sufficient in cases in which either marked adhesion is expected in the area of the circumflex artery or if anastomosable branches are not available in the area of the circumflex artery. This surgical technique was found to be an effective modality for a reoperation of the coronary artery, if suitable cases are carefully selected.