Off-pump coronary artery bypass grafting as re-do surgery in two cases in which the right gastroepiploic artery was grafted to the right coronary artery.

Transdiaphragmatic off-pump coronary artery bypass grafting (OPCAB) to the right coronary artery, is an effective way to reduce the risks of second bypass surgery as well as the risk of graft injury after coronary artery bypass grafting (CABG). We report two cases of successful OPCAB as re-do surgery in which the right gastroepiploic artery (RGEA) was grafted to the right coronary artery. The first case was a 58-year-old woman, who underwent CABG 10 years ago. OPCAB (RGEA to right coronary artery) was performed since myocardial perfusion scintigraphy revealed ischemia in the inferior wall. The second case was a 67-year-old man who had hypertension, hyperlipidemia, peripheral arterial disease, and was undergoing dialysis (for 6 years). Six years previously, he developed a mycotic aneurysm of the right coronary artery and underwent open-heart surgery. He often had episodes of angina at night or during dialysis, and then developed congestive heart failure and was hospitalized. Since ischemia was considered to be in the inferior wall, the RGEA was grafted to the right coronary artery.