[Redo Off-pump Coronary Artery Bypass for Postoperative Vein Graft Stenosis of Anomalous Origin of the Left Coronary Artery from the Pulmonary Artery;Report of a Case].

Bland-White-Garland (BWG) syndrome (anomalous origin of the left coronary artery from the pulmonary artery) is a rare disease which may result in myocardial infarction, congestive heart failure or sometimes death during the early infantile period. We present a 57-year-old female with BWG syndrome. At the age of 20, she was diagnosed with BWG syndrome and underwent coronary artery bypass grafting of a saphenous vein to the proximal portion of the anterior descending branch of the left coronary artery and ligation of the anomalous artery. Thirty-seven years later, she presented with symptoms of angina pectoris and congestive heart failure. Coronary angiography (CAG) revealed stenosis of the saphenous vein graft. Bare metal stent implantation for the saphenous vein graft was performed, but at the 6 months' follow-up CAG revealed restenosis. Drug-eluting stent was then implanted, but in-stent restenosis recurred 4 months later. We performed off-pump coronary artery bypass grafting to the left anterior descending artery using the left internal thoracic artery. The postoperative course was uneventful.