RT Book, Section
A1 Gonzalez-Stawinski, G. V.
A1 Lytle, Bruce W.
A2 Cohn, Lawrence H.
SR Print(0)
ID 55918422
T1 Chapter 26. Coronary Artery Reoperations
T2 Cardiac Surgery in the Adult, 4e
YR 2012
FD 2012
PB The McGraw-Hill Companies
PP New York, NY
SN 978-0-07-163310-9
LK accesssurgery.mhmedical.com/content.aspx?aid=55918422
RD 2024/04/20
AB Coronary  artery  reoperations  are  more  complicated  than  primary  operations.  Patients  undergoing  reoperations  have  distinct,  more  dangerous  pathologies;  reoperations  are  technically  more  difficult  to  perform;  and  the  risks  are  greater.1–12  Vein  graft  atherosclerosis,  present  in  most  reoperative  candidates,  is  a  unique  and  dangerous  lesion.  Reoperative  candidates  commonly  have  severe  and  diffuse  native-vessel  distal  coronary  artery  disease  (CAD),  a  problem  that  has  had  the  time  to  develop  only  because  these  patients  did  not  die  from  their  original  proximal  coronary  artery  lesions.  Aortic  and  noncardiac  atherosclerosis  are  also  often  far  advanced  in  many  reoperative  candidates.  Some  technical  hazards,  including  the  presence  of  patent  arterial  grafts  and  sternal  reentry,  are  unique  to  reoperations,  and  others,  such  as  lack  of  bypass  conduits  and  difficult  coronary  artery  exposure,  are  common.