Abstract
The antiphospholipid syndrome (APS) is a systemic autoimmune disorder characterized by a combination of arterial and/or venous thrombosis. We report a young adult patient of APS associated with systemic lupus erythematosus (SLE), who underwent off pump coronary artery bypass grafting for angina pectoris. She had been diagnosed with SLE at 12 years of age. Two years later, she suffered from right thalamencephalon infarction and was diagnosed as having antiphospholipid syndrome (APS) based on elevation of anticardiolipin antibodies. During twelve years until 26 years old, various thromboembolic and bleeding events occurred in the patient. At 30 years of age, she admitted to our hospital with high fever and the computed tomography detected de-novo cerebral arterial aneurysm. This suggested active vasculitis. On this admission, the ST pattern in the electrocardiogram was changed. Severe stenosis of left anterior descending coronary artery (LAD) and total occlusion of right coronary artery (RCA) were identified by coronary angiography (CAG). We performed off pump coronary artery bypass using saphenous vein grafts because of occlusion of bilateral intrathoracic arteries. The postoperative course was uneventful without any thromboembolic and bleeding complications. Postoperative CAG showed good patency of both vein grafts to LAD and RCA.
