%0 Case Reports
%T Minimally invasive direct coronary artery bypass to the left anterior descending artery using right gastroepiploic artery graft for a redo case with poor conduits.
%A Watanabe S
%A Arayawudhikul N
%J Indian J Thorac Cardiovasc Surg
%V 38
%N 2
%D Mar 2022
%M 35221559
暂无%R 10.1007/s12055-021-01285-z
%X A 64-year-old Thai woman underwent coronary artery bypass grafting (CABG) using saphenous vein grafts (SVG) for completely occluded left anterior descending artery (LAD) and mitral valve replacement with mechanical valve about a year ago. She presented with unstable angina. Three-dimensional computed tomography angiography (3DCTA) showed occlusion of all the grafts. The left subclavian artery had 99% stenosis. The patient underwent redo CABG via a minimally invasive direct approach. The chest was entered through the left fifth intercostal space. The right gastroepiploic artery (RGEA) and a small length of SVG were harvested. The RGEA was extended using the SVG with an end-to-end anastomosis and used to graft the LAD without cardiopulmonary bypass. The patient's postoperative course was uneventful. Postoperative 3DCTA revealed patent RGEA-SVG graft. Minimally invasive direct coronary artery bypass to LAD with RGEA is a useful alternative approach for redo CABG in patients with not much choice of conduits.