Repeated Coronary Artery Bypass Grafting of Circumflex Artery Branches on a Beating Heart through the Left Lateral Thoracotomy

Together with improving long-term survival after cardiac surgical interventions, the number of redo cardiac surgical procedures has increased. These procedures are of greater technical complexity, and there is heightened concern of injury of cardiac structures and previously placed bypass grafts. The mortality rate of redo CABG is generally higher than that of primary CABG, especially in emergency cases. The main reason for the high mortality rate is myocardial damage as a result of dissection of the pericardial adhesions, damages of patent grafts and right ventricle [1-4]. A redo CABG using the left thoracotomy to avoid the risks associated with resternotomy has been reported. This technique for redo CABG was first described in 1982 for grafting of circumflex artery branches in conditions of hypothermic artificial circulation and ventricular fibrillation [5]. Subsequently, redo cases were performed through the left thoracotomy on beating heart. In our country the first redo CABG through left thoracotomy on beating heart was performed in Petersburg Regional Clinical Hospital, 1998 (Schneider, J.A. [6]).