All-Arterial In Situ Bypass for Coronary Artery Stenosis in a Patient With Syphilis.

A 61-year-old man with syphilis was diagnosed with 3-vessel coronary artery disease. Syphilis causes aortitis, which progresses over time, even with appropriate treatment of the syphilis infection itself. Aortitis leads to coronary ostial stenosis and failure of the bypass graft to the ascending aorta. The patient underwent off-pump coronary artery bypass with an all-arterial in situ graft, and he recovered uneventfully. We herein present the ideal bypass design and follow-up results after surgical procedure in a patient with syphilis.