INTERNAL THORACIC ARTERY MALPERFUSION SYNDROME AFTER BILATERAL INTERNAL THORACIC ARTERY GRAFTING - REPORT OF A CASE

A 58-year-old man with postinfarction unstable angina was referred to the Department of Cardiovascular Surgery at the Saiseikai Kitakami Hos pital for urgent coronary revascularization, The bilateral internal th oracic arteries (ITAs) were subsequently utilized to revascularize the myocardium, The left anterior descending artery (LAD) was revasculari zed with the in situ right ITA and the obtuse marginal artery was reva scularized with the in situ left ITA, Although he was successfully wea ned from cardiopulmonary bypass, he collapsed hemodynamically 15 min l ater, Thus, he underwent supplementary vein bypass grafting to the dis tal LAD and the diagonal artery. Postoperatively, his course was uneve ntful, apart from the perioperative infarction, and a coronary arterio gram demonstrated patent bilateral ITAs and vein graft. This case repo rt emphasizes the importance of early recognition of this rare syndrom e and advocates surgical treatment consisting of supplementary vein gr afting.