Abstract
For the redo off-pump coronary artery bypass grafting (OPCABG) for multivessel disease including the left main trunk, an atypical procedure was selected in which a proximal anastomosis of a saphenous vein graft (SVG) was made to a previous SVG through a left thoracotomy approach. The patient was on hemodialysis and had undergone repeated percutaneous coronary interventions for angina. OPCABG had been performed for three-vessel disease in another hospital; however, only bypasses were performed for the LCX #14 and RCA #4 with a SVG because of severe calcification of the LAD. For the repeat surgery, based on the patient’s background and baring in mind that only a short time had elapsed since the initial surgery, a thoracotomy approach, graft and the method of proximal anastomosis was considered. As a result, the bypasses for LAD and #12 was performed by above described procedures. Postoperative coronary CT angiography showed that the patency of the graft was good.
