title: [H-graft minimally invasive direct coronary artery bypass for coronary artery disease complicated with Leriche syndrome].
abstract: We present a case of Leriche syndrome, requiring coronary revascularization and both lower extremities. Leriche syndrome shows high aortic occlusion, which has occasionally large collateral pathways from the internal thoracic artery (ITA) to the femoral artery via superior and inferior epigastric arteries. Usual usage of ITA may lead to deterioration of blood supply to lower extremities at surgical coronary revascularization. H-graft minimally invasive direct coronary artery bypass (MIDCAB), which puts arterial graft horizontally between in situ left ITA (LITA) and left anterior descending (LAD) through small incision approach, enables surgical LAD revascularization and keeps blood supply to lower extremities. H-graft MIDCAB contributed to two-stage surgery in a patient with Leriche syndrome complicated with coronary artery disease.
authors.affiliation: Department of Cardiovascular Surgery, Caress Sapporo Hakko Memorial Hospital, Sapporo, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Kawashima
authors.forename: S
authors.initials: S
authors.lastname: Naraoka
mesh_terms: D003097:Collateral Circulation; D001026:Coronary Artery Bypass / Q000295:instrumentation / Q000379:methods*; D003324:Coronary Artery Disease / Q000209:etiology / Q000601:surgery*; D006801:Humans; D007925:Leriche Syndrome / Q000150:complications*; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D009204:Myocardial Revascularization