{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T16:49:14Z","timestamp":1791823754567,"version":"4.3.4"},"reference-count":19,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T00:00:00Z","timestamp":1784160000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T00:00:00Z","timestamp":1791763200000},"content-version":"vor","delay-in-days":88,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Cardiothorac Surg"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Redo coronary artery bypass grafting (Redo-CABG) poses significant challenges due to complex coronary anatomy and limited conduit availability. In patients with a previously patent left internal mammary artery (LIMA), reusing it as an inflow source for total arterial revascularization (TAR) may offer a durable, stroke-sparing strategy. This study evaluated the safety and midterm outcomes of reusing a patent LIMA as an inflow source in Redo-CABG.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective case series included 24 patients who underwent Redo-CABG at Faghihi and Dena Hospitals (Shiraz University of Medical Sciences) between March 2015 and October 2023. Consecutive patients were included to minimize selection bias. All patients had a patent LIMA confirmed by angiography or computed tomography angiography (CTA). Arterial grafts (right internal mammary and\/or radial artery) were anastomosed to the patent LIMA to achieve complete TAR. Outcomes included perioperative complications, graft patency on CTA, and midterm major adverse cardiac or cerebrovascular events (MACCE).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>All patients achieved complete TAR with no hospital or 30-day mortality. One patient required reoperation for bleeding. Mean postoperative ejection fraction was 44.5\u2009\u00b1\u20094.6%, and mean ICU stay was 3.1\u2009\u00b1\u20090.9 days. Early postoperative CT angiography (at 3 months) and midterm follow-up imaging (median 3.5 years; completed in a subgroup of 12 patients) demonstrated complete graft patency in all evaluated conduits, with no recorded MACCE.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Reusing a patent LIMA as an inflow source for total arterial grafting in Redo-CABG appears to be a feasible and safe alternative for high-risk patients with limited conduit options. This approach minimizes extensive aortic manipulation, potentially offering a theoretical advantage in minimizing neurological risks. However, the retrospective, single-center design and small sample size preclude definitive conclusions regarding superiority, warranting further comparative evaluation in larger multicenter studies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s13019-026-04543-6","type":"journal-article","created":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T07:44:38Z","timestamp":1784187878000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Aorta-sparing total arterial redo-CABG using a recycled patent LIMA: a consecutive 24-patient series with midterm clinical and computed tomographic outcomes"],"prefix":"10.1186","volume":"21","author":[{"given":"Ahmad Ali","family":"Amirghofran","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7466-7487","authenticated-orcid":false,"given":"Alireza","family":"Arzhangzadeh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9891-9952","authenticated-orcid":false,"given":"Soorena","family":"Khorshidi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salma","family":"Nozhat","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Javad","family":"Kojuri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-4060-5593","authenticated-orcid":false,"given":"Mahsa","family":"Borjzadehgashtaseb","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8534-2880","authenticated-orcid":false,"given":"Mohammad Rafati","family":"Navaei","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,7,16]]},"reference":[{"issue":"1","key":"4543_CR1","doi-asserted-by":"publisher","first-page":"7","DOI":"10.1016\/j.ahj.2003.11.027","volume":"148","author":"K Okrainec","year":"2004","unstructured":"Okrainec K, Banerjee DK, Eisenberg MJ. 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