Reoperative Aortic Valve Replacement After Previous Coronary Artery Bypass Grafting or Aortic Valve Replacement

Redo surgery after prior coronary artery bypass grafting (CABG) is becoming more common. Often, a degenerative, stenotic aortic valve is the primary indication for such an operation. Additionally, a failing mechanical or bioprosthetic valve also necessitates re-operation. These operations present some unique challenges, including safe sternal re-entry, preservation of patent grafts, identification and control of internal mammary artery grafts, and careful planning of the aortotomy. In this report, we describe our technique for conducting this operation safely.