医学
旁路移植
血运重建
动脉
解剖(医学)
冠状动脉疾病
胸内动脉
心脏病学
外科
内科学
心肌梗塞
作者
Benjamin Yang,Marijan Koprivanac,Faisal G. Bakaeen
出处
期刊:Current Opinion in Cardiology
[Ovid Technologies (Wolters Kluwer)]
日期:2024-08-13
被引量:1
标识
DOI:10.1097/hco.0000000000001169
摘要
Purpose of review Redo coronary artery bypass grafting (CABG) remains technically challenging with significant procedural risk but may be the best option for patients in whom repeat revascularization is indicated. This review summarizes the latest data regarding risk of redo CABG, who should receive this surgery, and how to achieve best outcomes. Recent findings Over the past two decades, the risk of performing redo CABG has declined and is approaching that of primary CABG in the hands of experienced surgeons. Nonetheless, patients for whom redo CABG is indicated tend to be older and have more complex medical comorbidities. Preoperative imaging is paramount in guiding sternal re-entry and mediastinal dissection, and in how to best employ rescue strategies when needed. Summary Patients with complex, progressive coronary disease with unprotected left anterior descending (LAD) coronary artery disease and prior coronary bypass may benefit from the durable, complete revascularization that redo CABG can offer with internal thoracic artery bypass to the LAD and, when possible, arterial inflow to other important coronary targets. Preoperative imaging, careful planning, meticulous surgical technique, myocardial protection, and an experienced surgical team are critical for optimal outcomes.
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