Successful REDO CABG Surgery [At Lilavati Hospital]

Dr. Pavan Kumar, Dr. S Borkar, Dr. Amit Modi, Dr. N Kothari, Dr.Asmita Hegde

Department Of Cardiac Surgery

A 56 year old gentlemen was admitted in Lilavati Hospital under the care of Dr. Pavan Kumar. This patient had history of multiple cardiac interventions in the form of multiple coronary angioplasties (PTCA ) and coronary artery bypass surgery( CABG).

1st PTCA was done in 1988, following that he underwent first CABG in 1989. In this operation LIMA was grafted to LAD and sequential SVG to PDA and OM3 was done. Patient reminded asymptomatic for six years and in 1995 he developed angina again.

He was subsequently angiographed again which showed blocked SVG but functional LIMA. Blocked SVG was balloon dilated and stented. Subsequently, he became asymptomatic for another 6 years. In 2001 he developed, mild angina which was treated medically till January 2004.

In Jan 2004, his angina increased despite optimum medical treatment. He underwent a repeat coronary angiography which revealed new obstructive lesion in LAD just at the LIMA – LAD anastomosis and blocked SVG to PDA with new disease in OM2 coronary vessel with good LVEF. He underwent repeat CABG on February 4,2004 by Dr. Pavan Kumar. The surgeon used RIMA to bypass LAD block and ( Lt) Radial
Artery was used for PDA block.OM2 was bypassed by using SVG. The whole procedure lasted 5 hours with smooth uneventful post operative recovery. This case demonstrates use of RIMA across the sternum to bypass LAD block successfully.