关键词: 冠状动脉旁路移植术, 非体外循环, 移植

Abstract: Objective   Summarize the clinical experiences and features of performing redoCoronary artery bypass grafting（redoCABG）through a modified left posterolateral thoracotomy pathway.Methods  From July 2014 to Mar 2016，two cases of patients were underwent redoCABG operation through the left fifth intercostal incision.
Using a common rib spreader,enter the chest through the left fifth rib.Gradually dissociate from the apex of the heart into the pericardium and separate the original adhesive surface.The target vessels were reasonably exposed and identified as the distal anastomosis area.The great saphenous vein or small saphenous vein were used as the vascular bridge,the lower pulmonary ligaments were dissociated,and the descending aorta was taken by the lateral wall forceps as the proximal anastomosis,so as to conduct the redoCABG.Results  Offpump redoCABG was performed on these two patients successfully.The mean operative time was 182 min，distal anastomotic sites were 2～3.No 30day mortality was reported and no operation related death or complications were reported during follow up.Conclusion  Offpump redoCABG through a modified left posterolateral thoracotomy pathway was safe and available method for patients who need to receive reoperation therapy.

Key words: coronary artery bypass grafting,  , offpump,  ,  , transplantation