Axillary-coronary artery bypass reconstruction as an alternative in coronary artery reoperations

Background and Aims: The increasing incidence of reoperations in coronary s urgery associated with higher perioperative risks is a challenge for refine ment of the surgical methods. The aim of the work is to prove the feasibili ty and satisfactory intermediate results of minimally invasive axillary-cor onary artery bypass reconstruction in redo coronary surgery in case the lef t internal mammary artery had already been harvested. Material and Methods: Three patients (six months, two and six years after p rimary coronary artery bypass grafting) admitted for redo coronary surgery because of a recurrence of angina and proven malfunction of the left intern al mammary artery - left anterior descending coronary artery anastomosis. A n axillary-coronary venous graft was performed via left anterior small thor acotomy (LAST) on a beating heart in all three cases. esults: Excellent patency of the graft was noted on control angiography wit hin 9 days after the procedure together with good clinical improvement in m idterm followup. Conclusion: Minimally invasive axillary-coronary artery bypass via LAST acc ess in redo coronary surgery is a good alternative in cases where the left internal mammary artery cannot be used.