Coronary reoperation via small laparotomy using right gastroepiploic artery without CPB.

The elective use of the right gastroepiploic artery as an in situ graft has been well established in coronary surgery. We propose a surgical technique for patients undergoing coronary reoperations with a patent mammary graft to the left anterior descending artery. The gastroepiploic artery is used through a small laparotomy when only the right coronary artery or the posterior descending artery needs revascularization. The described technique allows avoidance of both resternotomy and cardiopulmonary bypass.