Re-operative aortic valve replacement via upper partial re-sternotomy in
a patient with patent internal thoracic artery after coronary artery
bypass grafting: A case report
A 71-year-old man who had undergone coronary artery bypass grafting with
left internal thoracic artery (LITA) and saphenous vein graft (SVG) 7
years previously was referred to our hospital for dyspnea on exertion.
Transthoracic echocardiography (TTE) showed severe aortic stenosis and
regurgitation. Contrast-enhanced computed tomography revealed patent
LITA anastomosed to the left anterior descending (LAD) coronary artery
and SVG to the left circumflex artery near the ascending aorta.
Re-operative aortic valve replacement (AVR) was performed via upper
partial re-sternotomy through an inverted T-shaped incision. The patent
LITA was dissected and clamped successfully with minimal adhesion
detachment. Postoperative TTE revealed a patent LITA anastomosed to LAD.
No complications occurred, and the patient was discharged on
postoperative day 17.