AORTA NO-TOUCH TECHNIQUE FOR THIRD TIME CORONARY ARTERY BYPASS GRAFTING (RE-RE-CABG)
The increasing number of reoperative CABG procedures is primarily a function of progressive atherosclerosis affecting the saphenous vein grafts and native coronary arteries in patients who underwent a CABG procedure at an early age. During the first year after surgery, up to 20% of venous grafts occlude; between 1 and 6 years, the graft attrition rate is 1% to 2% per year; and between 6 and 10 years, it is 4% per year. Ten years after surgery, only 60% of vein grafts are patent, and only 50% of patent vein grafts are free of significant stenosis. Reflecting this graft attriton, angina recurs in up to 20% of patients during the first year after surgery and in approximately 4% of patients annually. The incidence of reoperation after primary CABG (REDO) is approximately 3% at 5 years, 11% at 10 years, and greater than 17% at 12 years. Despite the increasing number of reoperations for coronary revascularization only minimal data are available concerning patients undergoing a third time CABG (RERE-CABG). RE-RE-CABGs are not so frequent; but these patients constitute a special group, which may increase in the coming years. In this report we describe the short-term results and the clinical status of a patient after RE-RE-CABG without touching the aorta, using arterial grafts.