Redo Endoscopic Assisted Coronary Artery Bypass Grafting In An 86-Year-Old Patient: A Case Report And Technical Review.

Source: PubMed, NCBI / U.S. National Library of Medicine

Redo cardiac surgery following a prior sternotomy presents significant technical challenges and increased risks due to potential injuries during sternal re-entry, mediastinal adhesions, and hemorrhage. Endoscopically assisted coronary artery bypass grafting offers a minimally invasive alternative approach, avoiding sternotomy while achieving complete revascularization and reducing operative morbidity. An 86-year-old male with prior coronary artery bypass grafting in 2011 who presented with recurrent angina due to graft occlusion and a circumflex lesion unsuitable for intervention. Revascularization was performed using thoracoscopic adhesiolysis and internal mammary harvesting, followed by a hand-sewn coronary anastomosis through a limited left thoracotomy under femoral cardiopulmonary bypass. The patient recovered uneventfully and was discharged on postoperative day six. At one-month follow-up, he remained asymptomatic with preserved ventricular function. Endoscopically assisted coronary bypass grafting is a safe and feasible alternative in selected patients while reducing surgical trauma and allowing rapid recovery.