[A case of infantile coronary artery bypass grafting with only left internal thoracic artery]

A 13-year-old girl performed two coronary artery bypass grafting with only left internal thoracic artery. She had no symptoms but was pointed out the abnormality in ECG (ST depression of V4 and V5) at junior high school. According to a coronary angiogram, she was diagnosed as double coronary vessels disease (a total occlusion on the proximal left anterior descending and a stenosis of 90% on the left high lateral artery). She performed sequential coronary artery bypass grafting to the left anterior descending artery and high lateral artery with only left internal thoracic artery. The anastomotic site on the left anterior descending artery showed slight thickness of the internal lumina and chronic inflammation. However they could not detect the pathological diagnosis. The postoperative course was uneventful. The postoperative angiographic control demonstrated a good patency with much blood flow of the left internal thoracic artery graft sequentially anastomosed to the left anterior descending artery and high lateral artery. The postoperative electrocardiogram became normal. She discharged on the 19th postoperative day. The sequential coronary artery bypass grafting with the left internal thoracic artery was effective for infantile ischemic heart disease.