Total venous coronary artery bypass grafting for acute myocardial infarction with Leriche syndrome and porcelain aorta: a case report.

Leriche syndrome is an occlusive disease involving the abdominal aorta and iliac arteries that is frequently associated with ischemic heart disease (IHD). The internal thoracic arteries in patients with Leriche syndrome often serve as important collateral pathways to the lower extremities. Therefore, graft selection for coronary artery bypass grafting (CABG) requires special consideration. We performed on-pump total venous CABG in a patient with acute heart failure secondary to IHD complicated by Leriche syndrome who required emergent coronary revascularization. This strategy was chosen to preserve lower limb perfusion. When coronary revascularization is a priority for patients with IHD complicated by Leriche syndrome, on-pump total venous CABG is a reasonable option because of the need to preserve lower limb perfusion and difficulty of using mechanical circulatory support devices for occlusive disease.