Three-Dimensional Surgical Strategy Planning With 3D Slicer for Redo Coronary Artery Bypass Grafting After Acute Aortic Dissection Repair.

Redo coronary artery bypass grafting after thoracic aortic surgery is challenging because of altered anatomy and dense adhesions. We report redo revascularization for right coronary ischemia 3 months after repair of acute type A aortic dissection. Contrast-enhanced computed tomography analyzed with 3D Slicer localized the right coronary artery crux relative to the thoracic cage and simulated right gastroepiploic artery routing and length. This enabled a sternotomy-sparing, off-pump right gastroepiploic artery to right coronary artery bypass with uneventful recovery; postoperative computed tomography confirmed graft patency.