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  • Title: [Mistaken grafting to diagonal branch in minimally invasive direct coronary artery bypass: a case required reoperation].
    Author: Sato K, Kosakai H, Kumabe S, Nakamura S, Anzai H, Tezuka N, Nakajima R.
    Journal: Kyobu Geka; 2000 May; 53(5):408-11. PubMed ID: 10808292.
    Abstract:
    The patient was a 75 year-old male who was admitted with recurrent chest pain during hemodialysis one year after PTCA to the right coronary artery and left circumflex branch (LCX). He had the history of cerebral infarction and chronic renal insufficiency. Coronary angiography showed severe stenosis from the left main trunk to left anterior descending artery (LAD) and restenosis at the PTCA site of LCX. The LCX lesion was dilated with PTCA. Minimally invasive coronary artery bypass (MIDCAB) with left internal thoracic artery (LITA) to LAD was carried out uneventfully. However, chest pain appeared on 1 POD. LITA angiography revealed that LITA was anastomosed to the diagonal branch that had occluded completely in the preoperative angiography. Off-pump CAB to LAD using inferior epigastric artery was carried out through median sternotmy on the same day. He recovered smoothly, and LITA angiography before discharge demonstrated that both grafts to LAD and diagonal branch are patent.
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