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Off-pump coronary artery bypass grafting in a patient with chronic myelomonocytic leukemia

Kazuhiro Ito1, Hideyuki Kawachi, Katsuhiko Nishiyama

  • 1Department of Thoracic and Cardiovascular Surgery, Saiseikai-Suita Hospital, Osaka, Japan.

Japanese Heart Journal
|June 27, 2003
PubMed

Insights

Off-pump coronary artery bypass grafting is a safe and effective procedure for high-risk patients with chronic myelomonocytic leukemia and coronary artery stenosis. This surgical approach prevented further cardiac events in a leukemia patient.

Area of Science:

  • Cardiology
  • Oncology
  • Cardiovascular Surgery

Background:

  • Chronic myelomonocytic leukemia (CMML) is a myeloid malignancy associated with increased cardiovascular risk.
  • Left main coronary artery stenosis is a critical condition requiring timely intervention.

Observation:

  • A 71-year-old male with CMML experienced two episodes of cardiogenic shock due to left main coronary artery stenosis.
  • The patient underwent off-pump coronary artery bypass grafting (OPCAB) using the left internal thoracic artery to revascularize the left anterior descending artery.

Findings:

  • The patient experienced no postoperative complications, including infection, leukemic transformation, or cardiac events.
  • OPCAB was successfully performed without cardiopulmonary bypass, demonstrating technical feasibility in this high-risk patient.

Implications:

  • Off-pump coronary artery bypass grafting is a viable and safe surgical option for patients with hematologic malignancies and severe coronary artery disease.
  • This case highlights the importance of addressing coronary artery disease aggressively, even in patients with complex comorbidities like leukemia.

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