Redo Coronary Artery Bypass Grafting

Redo CABG is required in symptomatic patients where surgical revascularization is indicated.

Redo CABG is mostly required in patients who suffer from co-morbid conditions like, sclerotic coronary and non cardiac arteries, when there seems to be no other practical options to help them improve and feel better. The redo procedure is considered as the last effort by the doctor to save patients with vein graft failure alone or combined with other causes from the death.

In comparison to PCI, CABG Redo Surgery is preferred in patients with more disease vein grafts and/or low cardiac function. Redo CABG is also preferred in patients with severe symptoms or extensive ischemia.

It is also recommended in patients with risked left anterior descending artery (LAD).

In patients with freshly occluded saphenous vein graft (SVG), CABG is indicated if the native artery appears unsuitable for PCI or when many of the important grafts are occluded.

Redo CABG is also considered if the patient has several diseased grafts, reduced left ventricular (LV) function, several chronic total occlusion (CTO), or absence of a patent internal thoracic artery (ITA).

ITA is often the choice of conduit in most of the redo CABG surgeries.

Patients planned for redo CABG should have at least one coronary artery that is graftable with ischemic territory and is also viable.

Redo CABG is Superior choice of surgery than PCI in following conditions:

• Better chances of survival
• Freedom from cardiac events and recurrent angina
• Patient can lead a normal life with minimum medications
• Comparably effective than other procedures in patients with co-morbid conditions

Redo coronary artery bypass grafting (CABG) is quite a challenging procedure than the primary CABG as it requires reentry into the sternum as well as opening of the heart. That is why it requires far better skills and expertise of a cardiac surgeon to perform a redo by-pass surgery than a primary CABG. It is an extremely demanding surgery in terms of surgeon skills as well as patient care after redo surgery.

But with growing technology, the redo CABG procedure has become almost as safe as the primary CABG operation if performed by an experienced surgeon in a hospital with complete infrastructure. The outcomes of redo CABG have also been improving in recent times despite of the patients having comorbid conditions.