[Off-pump coronary artery bypass grafting with large cerebral infarction; report of a case]

Area of Science:

• Cardiology
• Neurology
• Cardiothoracic Surgery

Background:

• A 48-year-old male presented with acute myocardial infarction (AMI).
• The patient had a significant past medical history of cerebral infarction 26 years prior, resulting in left hemiparesis.
• Coronary angiography identified left main trunk and multi-vessel disease, unsuitable for catheter intervention.

Observation:

• Brain computed tomography (CT) revealed a large right-sided cerebral infarction.
• The patient underwent off-pump coronary artery bypass grafting (OPCAB) for his cardiac condition.
• Postoperatively, the patient's pre-existing hemiparesis did not progress.

Findings:

• Off-pump coronary artery bypass grafting (OPCAB) was successfully performed in a patient with acute myocardial infarction and extensive chronic cerebral infarction.
• The surgical procedure did not lead to any exacerbation of the patient's neurological deficits.

Implications:

• OPCAB may be a safe and effective revascularization strategy for patients with acute coronary syndromes and chronic, stable cerebral infarctions.
• This approach could be considered even in cases of large cerebral infarcts, provided neurological function is preserved.
• Careful patient selection and surgical technique are crucial when considering OPCAB in patients with comorbid cerebrovascular disease.