Repeated reconstruction of distal mammarocoronary anastomosis through left thoracotomy

The population of patients subjected to repeated revascularization has changed over the past twenty years. They are mostly elderly patients with multiple comorbidities. In addition to demographic changes, there are also changes in the results of various strategies used in CABG. The widespread use of arterial grafts during CABG leads to an increase in the period between primary surgery and repeated one. However, in some cases there occurs a dysfunction of arterial shunts. MIDCAB is an excellent option for surgical treatment of patients with an isolated lesion of LAD and it can be also used to repair mammarocoronary shunt defects. The authors report a case of successful repeated reconstruction of mammarocoronary anastomosis from lateral thoracotomy in a patient with angina relapse after previous ITA-LAD grafting complicated with sternum osteomyelitis followed by its resection and plasty.