Off-pump LIMA-RIMA Y graft: a practical option in adult-type ALCAPA.

A 29-year-old female was diagnosed to have adult-type anomalous left coronary artery from pulmonary artery (ALCAPA). She underwent a two-coronary system repair using left internal mammary artery and right internal mammary artery Y (LIMA-RIMA Y) off-pump coronary artery bypass grafting and made an uneventful postoperative recovery. The usage of off-pump LIMA-RIMA Y graft can be a suitable option for adult ALCAPA with a potential for good long-term outcomes.

Temporary clamping of branch pulmonary artery for pulmonary hemorrhage after endarterectomy.

A 49-year-old man underwent pulmonary thromboendarterectomy for chronic thromboembolic pulmonary hypertension. A massive pulmonary hemorrhage developed, which was identified to be from the right lower lobe, when weaning off cardiopulmonary bypass was attempted. He was managed by temporary overnight clamping of the right pulmonary artery, after the upper lobe branch.