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Simultaneous Off-pump Coronary Artery Bypass Grafting and Ascending Aorto-bifemoral Bypass in Leriche Syndrome
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（Department of Cardiovascular Surgery, Shiga University of Medical Science, Otsu, Japan）
| Noriyuki Takashima |
Tomoaki Suzuki |
Soh Hosoba |
| Takeshi Kinoshita |
Hiromitsu Nota |
Atsushi Kambara |
| Yasuhiro Nagayoshi |
Tohru Asai |
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In the presence of Leriche syndrome, the lower extremities are perfused by collateral flow from internal mammary arteries. If an internal mammary artery graft is used in coronary artery surgery, an acute ischemic limb will develop postoperatively. A 52-year-old man was admitted to our department with bilateral claudication. Multidetector row computed tomography with contrast showed total occlusion of the infrarenal abdominal aorta and rich collateral flow to the lower extremities from internal mammary arteries. Cardiac angiography revealed three-vessel disease. Simultaneous coronary artery bypass grafting and an ascending aorto-bifemoral bypass were performed without cardiopulmonary bypass. Postoperative computed tomography angiography showed that grafts to the coronary and bifemoral arteries were patent. This combined procedure is useful for patients with coronary artery disease and aortoiliac occlusive disease. This procedure without cardiopulmonary bypass has not previously been reported.
Jpn. J. Cardiovasc. Surg. 41:152-155（2012）
Keywords：Leriche syndrome, ischemic heart disease, coronary artery bypass grafting
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