Off-pump coronary artery bypass grafting in a patient with beh?et’s disease

We report the case of a 58-year-old man with Beh?et’s disease who developed chest pain. Coronary angiography showed severe triple-vessel disease, and the patient was transferred to our department for urgent coronary artery bypass grafting. Because of the risk of anastomotic leakage or pseudoaneurysm formation, we performed off-pump coronary artery bypass grafting with the aortic no-touch technique. Postoperative coronary angiography showed that all the grafts were patent and no anastomotic pseudo-aneurysms were observed. Pathological examination of the right internal thoracic artery specimen revealed mild intimal thickening and disruption of elastic fibers in the medial layer, both of which are characteristics of Beh?et’s disease. These findings indicated that the patient must be monitored carefully for postoperative pseudoaneurysm formation.