A case report of emergency off-pump CABG in an aged patient with ACS renewing ventricular fibrillation.

An emergency off-pump coronary artery bypass (OPCAB) was performed successfully in an aged patient with acute coronary syndrome (ACS). The patient, an 80-year-old woman residing in a nursing home, suddenly lost consciousness during lunch. The electrocardiogram (ECG) showed ventricular fibrillation (Vf) but defibrillation successfully recovered the sinus rhythm. The patient was brought to our hospital as an emergency. She underwent emergency cardiac catheterization. Coronary angiography demonstrated severe three vessel disease with left main coronary trunk (LMT) stenosis. Even during intra-aortic balloon pumping (IABP), the hemodynamic state was unstable, with repeated development of ventricular tachycardia and fibrillation. An emergency coronary artery bypass without a cardiopulmonary bypass was performed. Saving her life was of primary importance and revascularization of the left anterior descending artery (LAD) branch, was performed. Thanks to the advances made in various devices, safe and reliable anastomoses have become possible in OPCAB applied to ACS. OPCAB for ACS have become safe and reliable anastomoses following development of various devices. We think that OPCAB is an effective surgical technique for coronary revascularization for emergency or serious cases involving elderly patients.