ABSTRACT
Since its inception during the late 1950s, coronary artery bypass grafting (CABG) has become commonplace. Given the vast number of these procedures performed over the last half century and the known limitations of vein graft patency, it is surprising to find that reoperative CABG has declined in the modern era to as low as 2.2% of all CABGs performed.1 There are multiple reasons for this including the increased use of arterial grafts, the effectiveness of percutaneous coronary intervention (PCI), and the availability of newer and better antilipid and antiplatelet drug options. An important factor driving the growth of PCI is that the risks of reoperative CABG remain high. Operative mortality, myocardial infarction, and prolonged ventilation occur at significantly higher rates in this group. The risks of injury to the heart as well as patent bypass grafts are always a concern and the presence of scar tissue as well as the progression of native coronary artery disease (CAD) can make the technical feasibility of reoperative CABG challenging.
