[Emergency coronary artery bypass grafting for left main trunk stenosis in a patient with systemic lupus erythematosus].

A 57-year-old female who had been treated for SLE with prednisolone for 11 years was transferred to our hospital due to unstable angina caused by stenoses of the left main trunk (LMT) and the left anterior descending artery (LAD). She underwent emergency coronary artery bypass grafting of the LAD and the left circumflex artery (LCX) using saphenous vein grafts (SVGs). Since we were afraid the internal thoracic arteries (ITAs) and right gastroepiproic artery were less usable because preoperative angiography showed too small (1.2 mm) ITAs and she had undergone Miles' operation for anal canal cancer, SVG usage seemed more advantageous as an emergency procedure. Pre- and postoperatively, leukocytopenia was treated with granulocyte colony stimulating factor and she was free from infection. She had no chest pain postoperatively. However, postoperative angiography confirmed an occluded SVG to the LCX and a patent SVG to the LAD which supplied blood flow to the LCX area.