HYBRID MYOCARDIAL REVASCULARIZATION AFTER PREVIOUS LEFT PNEUMONECTOMY

Previous intrapericardial left pneumonectomy and irradiation necessita ted an unorthodox, staged approach to myocardial revascularization in a patient with unstable angina pectoris, left main artery, and three-v essel coronary artery disease. A saphenous vein bypass graft was const ructed from the descending thoracic aorta to the left anterior descend ing coronary artery via left thoracotomy, without cardiopulmonary bypa ss. Two days later the patient underwent stenting of the left main and circumflex coronary arteries. Recovery was uneventful. (C) 1998 by Th e Society of Thoracic Surgeons.