Difficult CABG in the Era of Stenting

For the past three decades, coronary artery bypass grafting has been the standard treatment for patients with severe multivessel ischemic heart disease. in the past few years, however, it has been increasingly challenged by percutaneous coronary intervention. the increasing tendency to report interventional treatments being based on patient or physician preference is both inadequate and inappropriate, discussion of all interventions by a multidisciplinary team should be a minimum standard of care. in this report we present a patient with coronary artery disease who underwent coronary catheterization and stenting many times, and finally the decision was to do a coronary artery bypass grafting in which the saphenous vein anastomosis to the distal right coronary artery was done over an old stent.