Redo-coronary artery bypass grafting( redo-CABG) still remains a challenging operation and is associated with a significantly higher risk of morbidity and mortality when compared with primary CABG. The higher risk of redo-CABG is largely attributable to the increased technical difficulty and the greater incremental risk in redo-CABG patients. Annual reports by the Japanese Association for Thoracic Surgery in recent years reveled that the absolute and relative number of redo-CABG gradually decreased, and in-hospital mortality did not change significantly over this periods and was much higher than primary CABG. The increasing use of percutaneous coronary intervention (PCI) for previous CABG patients could be a reason for the decrease of redo-CABG, and therefore surgery of redo-CABG is becoming more limited. This paper presents the current indications, safe surgical technique, and perioperative management of redo-CABG patients, as well as the contemporary results of redo-CABG in our institution.
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