[Coronary artery bypass grafting using arterial grafts in a patient with rheumatoid arthritis requiring steroid therapy].

We report a 58-year-old man with rheumatoid arthritis (RA) who underwent successful coronary artery bypass grafting (CABG) for stable angina after myocardial infarction. He had been receiving prednisolone for 9 years. Selective coronary angiography revealed 99% stenosis in the left anterior descending branch (LAD; seg. 6). Before going on cardiopulmonary bypass, the inferior epigastric artery (IEA) was anastomosed to the left internal thoracic artery (LITA) in end-to-side fashion. The LITA was anastomosed to LAD (seg. 7) and the IEA was anastomosed to the first diagonal branch (seg. 9). The postoperative course was uneventful and postoperative angiography showed both grafts were well patent. He is now doing well with no angina attack. The stumps of the LITA and IEA were examined pathologically with the atherosclerotic changes of both grafts relatively mild. We consider the arterial grafts are useful for CABG even in the patient with RA requiring steroid therapy.