Coronary Artery Disease Affected by Moyamoya Disease

Kim, Hark Jei; Jo, Won Min; Rhu, Se Min; Hwang, Jae Joon; Sohn, Young Sang; Choi, Young Ho

Abstract

Moyamoya disease is an unusual cerebrovascular disorder characterized by occlusive intimal dysplasia of the distal internal carotid and proximal cerebral arteries as well as other collateral arteries. However,moyamoya diseases are recently being reported as a systemic process.We experienced one case of coronary artery occlusive disease affected by moyamoya disease.The patient was a 35-year-old female,experiencing intermittent NYHA class II dyspnea and exertional chest pain for 6 months and right parest hesi a f or 1 month before admission.Cerebral artery angiogram showed abnormal cerebrovascular systems and confirmed moyamoya disease with cerebral infarction of the left f r ont al l obe. I n cor onar yartery angiogram,left coronary artery was not visualized due to total occlusion of the left main ostium and left coronary blood flow was supplied from normal right coronary artery. CABG was performed with OPCAB.Both internal mammary arteries were used f or LAD and LCx.Intraoperative coronary artery findings showed intimal hyperplasia and no definite thrombi,and nondiseased coronary arteries were good and patent.We concluded that this patient's coronary artery disease was affected by moyamoya disease,and moyamoya disease should be evaluated in the extracerebral cardiovascular system.