Abstract
A 54-year-old female with pre-existing idiopathic moyamoya disease developed chest pain with acute myocardial infarction. Coronary angiography detected occluded and stenotic lesions in the coronary arteries. Right coronary artery stenosis was treated by balloon angioplasty and stenting. Because of the restenosis, on-pump cardiopulmonary bypass was performed. The operation was uneventful and no perioperative cerebral ischemic episode occurred. The conclusion is that on-pump cardiopulmonary bypass preserving intraoperative hemodynamic parameters at an optimal level is a safe procedure in a patient with moyamoya disease.
Highlights
First described in 1957, moyamoya describes a rare cerebral arteriopathy characterized by occlusive disease of the terminal internal carotid or proximal middle cerebral arteries and proliferation of lenticulostriate collaterals [1]
Right coronary artery stenosis was treated by balloon angioplasty and stenting
The conclusion is that on-pump cardiopulmonary bypass preserving intraoperative hemodynamic parameters at an optimal level is a safe procedure in a patient with moyamoya disease
Summary
First described in 1957, moyamoya describes a rare cerebral arteriopathy characterized by occlusive disease of the terminal internal carotid or proximal middle cerebral arteries and proliferation of lenticulostriate collaterals [1]. The steno-occlusive changes in moyamoya disease are believed to be confined to the intracranial arteries and rarely occur in the extracranial arteries, including only rare occurrences in the coronary arteries [2]. Extracranial vascular involvement has been reported mainly in the renal artery [3]. Coronary artery involvement among patients with moyamoya disease (MMD) is extremely rare [2]. We report an elderly female having ischemic heart disease with MMD who was successfully treated by on-pump coronary artery bypass grafting (ACBG)
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