Continuous coronary perfusion in redo aortic valve replacement following prior coronary surgery; an old trick for new dogs?

The optimal myocardial protection method for aortic valve replacement in the setting of prior coronary artery bypass surgery remains a subject of debate. Protection is particularly challenging when a patent pedicled internal thoracic artery graft supplies a proximally obstructed left anterior descending artery. Herein, we describe a modification of an old technique; continuous coronary perfusion, which can be used in selected, anatomically suitable cases.