A 54-year-old female with pre-existing
idiopathic moyamoya disease developed chest pain with acute myocardial
infarction. Coronary angiography detected occluded and stenotic lesions in
the coronary arteries. Right coronary artery stenosis was treated by balloon angioplasty and stenting. Because of the
restenosis, on-pump cardiopulmonary bypass was performed. The operation
was uneventful and no perioperative cerebral ischemic episode occurred. The
conclusion is that on-pump cardiopulmonary bypass preserving intraoperative hemodynamic parameters at an optimal
level is a safe procedure in a patient with moyamoya disease.