イチハラ　ユウキ   YUKI ICHIHARA   市原　有起    所属   医学部 医学科（東京女子医科大学病院）    職種   講師
言語種別	英語
発表タイトル	A Case Of Aborted Cardiac Death With Refractory Fatal Arrhythmia In A Patient After Off-pump Coronary Artery Bypass Grafting
会議名	5th International Coronary Congress
学会区分	国際学会及び海外の学会
発表形式	口頭
発表者・共同発表者	◎IKEHARA Masaaki, ICHIHARA Yuki, NIINAMI Hiroshi
発表年月日	2019/12/06
開催地 （都市, 国名）	New York, USA
概要	*Session 8: Friday Night at the Movies: Video Presentations From Around the World of Difficult/Unusual Cases, Innovative Techniques and Novel Devices in CABG Relevant History: The patient with diabetic nephropathy and a 3-year history of hemodialysis was detected to have old myocardial infraction (OMI) and depressed LV systolic function (EF 30%) during health check-up for renal transplantation. Coronary angiogram revealed 75% stenosis in the left ascending descending artery (LAD) and 90% stenosis in the middle of the left circumflex artery (LCx) and total occlusion in the posterior lateral branch (PL) of the left circumflex artery and the right coronary artery was hypoplasia. Pre-Operative Plan: We plan to do Off-pump canary artery bypass grafting (OPCAB) for LITA-LAD and GEA-4PD. Discussion of what was actually done and the challenges, deaths and complications encountered. (Unless case is still pending): The day after operation, the patient developed incessant wide QRS tachycardia and fibrillation unresponsive to arrhythmic drugs and cardioversion. We underwent percutaneous cardiopulmonary support (PCPS) and used arrhythmic drugs and cardioversion hundreds of times. However, the arrhythmia appeared many times so we perform catheter ablation twice and the arrhythmia was controlled. We underwent ICD implantation and the patient discharged on the fifth postoperative month. We herein report the case of a patient management presenting with incessant VT storm after OPCAB