title: Coronary artery bypass grafting for a patient with Tangier disease.
abstract: A 56-year-old man with Tangier disease suffering from angina pectoris due to triple-vessel coronary artery disease evidenced extremely low blood high-density lipoprotein of 1 mg/dl, a specific laboratory indicator of this rare genetic disorder of lipid metabolism, considered to accompany juvenile arteriosclerosis. Because of the calcified ascending aorta, we conducted combined minimally invasive coronary artery bypass (CAB) for the left anterior descending coronary artery and percutaneous transluminal coronary angioplasty for other coronary artery lesions initially instead of conventional coronary artery bypass grafting. Angina recurred, however, due to refractory restenosis of the left circumflex coronary artery lesion. Two years later, we redid the CAB, grafting the free right internal thoracic artery from the functional left internal thoracic artery sequentially onto obtuse marginal and posterolateral coronary arteries. The patient returned to work angina-free.
authors.affiliation: Department of Cardiovascular Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases, 1-1-3 Nakamichi, Higashinari-ku, Osaka 537-8511, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Takami
authors.forename: Tohru
authors.initials: T
authors.lastname: Kobayashi
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Nakagawa
authors.forename: Makoto
authors.initials: M
authors.lastname: Sakurai
authors.forename: Nobuhisa
authors.initials: N
authors.lastname: Awata
authors.forename: Shizuya
authors.initials: S
authors.lastname: Yamashita
mesh_terms: D000787:Angina Pectoris / Q000601:surgery; D006348:Cardiac Surgical Procedures; D001026:Coronary Artery Bypass; D003327:Coronary Disease / Q000601:surgery*; D023903:Coronary Restenosis / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D013631:Tangier Disease / Q000150:complications*