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Minimally invasive direct coronary artery bypass grafting in a patient with brainstem infarction
Y Sakakibara1, H Nakata, A Sasaki
1Department of Surgery, University of Tsukuba, Ibaraki, Japan.
Insights
Brainstem infarction, a rare condition linked to the primitive trigeminal artery, can occur alongside acute myocardial infarction. Coronary artery bypass grafting was safely performed in a patient 10 weeks post-brainstem infarction.
Area of Science:
- Neurology
- Cardiology
- Vascular Surgery
Background:
- Primitive trigeminal artery is a rare cerebral artery variant.
- Brainstem infarction is a type of stroke affecting the brainstem.
- Co-occurrence of brainstem and myocardial infarction presents unique clinical challenges.
Observation:
- A 61-year-old male presented with both acute myocardial infarction and brainstem infarction.
- The patient required coronary artery bypass grafting for his cardiac condition.
- The brainstem infarction was associated with the primitive trigeminal artery.
Findings:
- Minimally invasive direct coronary artery bypass grafting was successfully performed.
- The cardiac surgery was completed 10 weeks after the brainstem infarction episode.
- This case highlights the feasibility of cardiac intervention after neurological events.
Implications:
- Demonstrates the safety of delayed coronary artery bypass grafting in patients with prior brainstem infarction.
- Suggests careful pre-operative assessment and timing are crucial for managing complex cardiovascular and cerebrovascular cases.
- Contributes to understanding the management of patients with co-existing arterial anomalies and ischemic events.
Abstract:
Brainstem infarction associated with the primitive trigeminal artery is rare. We describe the case of a 61-year-old man with an acute myocardial infarction as well as a brainstem infarction. The patient was referred for coronary artery bypass grafting. Minimally invasive direct coronary artery bypass grafting (left internal thoracic artery to the second diagonal branch anastomosis) could be safely performed 10 weeks after an episode of brainstem infarction.