Coronary heart disease produced by pseudoxanthoma elasticum and coronary artery bypass with double internal mammary artery

We present a case of an 18 year-old woman with pseudoxanthoma elasticum, wh o had a biopsy taken from a lesion. Although she was asymptomatic, we tried to rule out myocardial ischemia with a treadmill and cardiac gammagraphy w ith Talio. The isotopic studies and the ergometry were positive and the pat ient underwent coronariography. This study showed a severe triple-vessel di sease. We did an angiography of the supraaortic arteries, mamarian artery, and mesenteric artery. These studies showed no obstructive lesions. The tre atment of patient was a double by-pass with internal mammary artery and one by-pass with safena vein grafts with satisfactory results.