An Operated Case of Coronary Artery Bypass Grafting in a Patient with Progressive Systemic Sclerosis / 日本心臓血管外科学会雑誌

ABSTRACT

There are few reports of successful CABG for coronary lesions due to collagen disease. In particular, there is no report of CABG in progressive systemic sclerosis (PSS). A 60-year-old female with PSS underwent successful coronary artery grafting for angina pectoris. She had a history of PSS and had been on predonisolon for the previous 2 years. Three months prior to admission, she began to complain of angina on mild exersion. Selective coronary angiogram revealed 90% stenosis in the midportion of the right coronary artery and 90% stenosis in the proximal portion of the left anterior descending artery. Based on these findings she underwent saphenous vein grafting to the left anterior descending branch and the posterior descending branch of the RCA. Despite the history of PSS, the patient's postoperative course was uneventful and she is now doing well with no attack of angina. Postoperative angiography showed both vein grafts were patent, but there was a slight stenotic lesion in the midportion of the graft to the right coronary artery. From our experience, careful consideration of the bypass conduit is important in patients requiring steroids.