| Abstract: | Re-operative coronary artery bypass graft (CABG) surgery is more complicated than the initial CABG and it may also be more hazardous because of risk factors related to median resternotomy, such as cardiac injury and damage to the patent grafts due to sternal adhesion.1 Deciding on the appropriate treatment for recurrent coronary artery disease (CAD), especially conditions such as non-left anterior descending coronary artery (LAD) ischaemic lesions during the existence of patent left internal thoracic artery-to-left anterior descending coronary artery (LITA–LAD) anastomosis is a dilemma.2If the patient is unresponsive to medical therapy, and percutaneous transluminal coronary angioplasty (PTCA) and/or stenting is not appropriate for revascularisation, alternative surgical strategies, excluding resternotomy and cardiopulmonary bypass (CPB), may be the most appropriate way of revascularising the branches of the circumflex artery (Cx) or right coronary arteries (RCA) (non-LAD territories).3-5 In selected patients, off-pump redo CABG for the branches of the Cx via a posterolateral thoracotomy may reduce the risks due to median resternotomy and dissection of the heart.This procedure to avoid resternotomy and CPB has become an established and popular way of revascularising recurrent coronary artery disease in the lateral aspect of the heart. In this article, we share our experience of 32 patients who underwent redo CABG for the Cx and its branches via a left posterolateral thoracotomy. |
