Minimal invasive direct coronary artery bypass in moyamoya disease.

A 56-year-old woman with moyamoya disease presented with angina pectoris. Coronary artery stenosis of atherosclerosis origin was resistant to repeated transluminal angioplasty. Coronary artery bypass grafting was performed by minimal invasive direct coronary artery bypass (MIDCAB), avoiding cardiopulmonary bypass and intraoperative hypotension. Since coronary artery bypass grafting on cardiopulmonary bypass for patients with moyamoya disease has a potential risk of brain ischemia, MIDCAB may avoid perioperative cerebral ischemic complication.