Three dimensional computed tomographic imaging in planning the surgical approach for redo cardiac surgery after coronary revascularization

Abstract

The 3D CT imaging technique is useful in defining the optimal surgical strategy for reoperative cardiac surgery. We found that CTA is superior to CXR and conventional angiography in defining the position of patent grafts and vital structures in relation to the midline and posterior sternum. Preoperative mapping of patent coronary grafts and other vital mediastinal structures reduces the morbidity of the reoperation through modification of surgical approaches.

The benefit of 64-MDCT prior to invasive coronary angiography in symptomatic post-CABG patients

“…It is, however, known that CAG may provide inadequate information to avoid injury during sternal re-entry to cardiac structures and bypass grafts which might adhere posterior to the sternum [24]. In literature, the importance of 16-MDCT prior to repeated heart surgery has been addressed and has in some clinics already been implemented [25][26][27]. 64-MDCT shows accurately the bypass grafts and coronary structures essential for planning surgery.…”

Heart–lung and lung transplantation in grown-up congenital heart disease: long-term single centre experience☆

“…Multidetector computed tomography has now been widely accepted as an appropriate noninvasive diagnostic tool for preoperative assessment of complex cardiac anatomy in re-operative heart surgery [9][10][11]. Three-dimensional reconstructions are particularly helpful in patients after operative correction of congenital heart disease, because they provide a clear visualisation of cardiac anatomy which is easily understandable not only for specialised paediatric cardiac surgeons.…”

The impact of symptom severity on cardiac reoperative risk: early referral and reoperation is warranted

“…Notably, various technical strategies described to reduce the risk of reoperation have focused on techniques of resternotomy [6,12,13], alternative surgical access including minimally invasive incisions and thoracotomy [8,[14][15][16], myocardial protection [5,17,18] and avoiding cardiopulmonary bypass [19][20][21]. Different combinations of these techniques [7,22] have also been associated with good outcomes.…”