Gastroepiploic Artery Minimally Invasive Grafting in Reoperative Patients With Patent Mammaries

Coronary artery bypass grafting without full sternotomy

“…By selecting the RGEA as a graft and using the transdiaphragmatic approach to the inferior wall, surgeons can avoid median sternotomy as well as CPB. 28 It is expected that adhesions around the heart from the primary surgery would act as a natural stabilizer to achieve a motionless fi eld. In redo bypass surgery for the LAD and diagonal branch, axillary-coronary artery bypass using the RA and SVG is an alternative approach, which does not require touching the previously placed grafts.…”

“…Glineur et al reported that the RGEA was confi rmed to be patent angiographically in 13 of 15 patients after 38 months of follow-up, but that angina had recurred in 21% after 56 ± 20 months of follow-up. 28 Kondo et al reported using the gastroduodenal artery (GDA) as infl ow when the RGEA was not available in a patient who had undergone gastrectomy whose RGEA was judged not to be suitable as a graft. 29 By making a composite graft using a free graft (RA, SVG), the RCA can be grafted via a diaphragmatic approach.…”

Avoiding sternotomy in repeat coronary artery bypass grafting: Feasibility, safety, and mid-term outcome of the transabdominal off-pump technique using the right gastroepiploic artery

“…4,5 When the right coronary artery (RCA) or the right posterior descending artery (PDA) is the only vessel involved, a small laparotomy with or without a T-shaped incision of the lower third of the sternum has been shown to be a useful alternative. [6][7][8] Despite the first successful experiences, reports of redo CABG without sternotomy and without CPB remain limited. In this study, we describe a 10-year experience with the transabdominal off-pump technique using the right gastroepiploic artery (GEA) involving 22 redo patients, emphasizing the feasibility and safety of this approach and its mid-term clinical outcomes.…”

Reoperative Off-Pump Right Subclavian Artery to Right Coronary Artery Bypass Grafting Without Full Sternotomy

“…A figure of L incision was used by Watanabe on the left chest combining a left anterior small thoracotomy and division of the costal margin for full arterial revascularization, including reoperations 7 . Resection of the xiphoid process with or without T‐shaped sternotomy was used by Glineur in reoperations for grafting the RCA with the right gastroepiploic artery 8 . The use of a subxiphoid approach with ministernotomy to harvest the right internal thoracic artery (RITA) and to revascularize the RCA in the second and third time operations was reported by Abraham and coworkers.…”

“…7 Resection of the xiphoid process with or without T-shaped sternotomy was used by Glineur in reoperations for grafting the RCA with the right gastroepiploic artery. 8 The use of a subxiphoid approach with ministernotomy to harvest the right internal thoracic artery (RITA) and to revascularize the RCA in the second and third time operations was reported by Abraham and coworkers. 9 The patency rate of subclavian to coronary artery vein grafts was reported to be 13/14 at a mean follow up of seven months.…”