{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T05:15:11Z","timestamp":1779167711824,"version":"3.51.4"},"reference-count":16,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T00:00:00Z","timestamp":1779062400000},"content-version":"vor","delay-in-days":137,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Case Reports in Anesthesiology"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Moyamoya disease is characterized by progressive stenosis of the internal carotid arteries and impaired cerebrovascular autoregulation, posing substantial challenges during cardiac surgery. Although coronary artery bypass grafting (CABG) has been reported in patients with moyamoya disease, anesthetic management during robot\u2010assisted beating\u2010heart CABG has not been reported.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case Presentation<\/jats:title>\n                    <jats:p>\n                      A 44\u2010year\u2010old woman with untreated moyamoya disease underwent robot\u2010assisted coronary artery bypass grafting (RACABG) for left anterior descending artery disease. One\u2010lung ventilation with intrathoracic carbon dioxide insufflation was required. Intraoperative anesthetic management was guided by regional cerebral oxygen saturation (rSO\n                      <jats:sub>2<\/jats:sub>\n                      ) monitoring to ensure adequate cerebral perfusion. Strict control of blood pressure and arterial partial pressure of carbon dioxide allowed cerebral oxygenation to be maintained within 20% of baseline throughout surgery. The patient was extubated without any neurological deficits. On Postoperative Day 4, the patient developed sudden cardiac arrest, most likely due to coronary artery spasm, which lasted for approximately 19\u2009min. She recovered fully without neurological impairment after cardiopulmonary resuscitation and percutaneous ventricular assist support.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      This case highlights the usefulness of rSO\n                      <jats:sub>2<\/jats:sub>\n                      \u2010guided anesthetic management with strict hemodynamic and carbon dioxide control during RACABG in patients with moyamoya disease. Vigilance for perioperative coronary vasospasm is essential in this population.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1155\/cria\/3262548","type":"journal-article","created":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T04:54:07Z","timestamp":1779166447000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Cerebral Oximetry\u2013Guided Anesthetic Management for Robot\u2010Assisted Beating\u2010Heart Coronary Artery Bypass Grafting in a Patient With Untreated Moyamoya Disease"],"prefix":"10.1155","volume":"2026","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-3162-6216","authenticated-orcid":false,"given":"Megumi","family":"Nagata","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Miho","family":"Suzuki","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takeyuki","family":"Sajima","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Atsushi","family":"Yasuda","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shigehito","family":"Sawamura","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,5,18]]},"reference":[{"key":"e_1_2_11_1_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.str.14.1.104"},{"key":"e_1_2_11_2_2","doi-asserted-by":"publisher","DOI":"10.1097\/ana.0b013e3181f84fac"},{"key":"e_1_2_11_3_2","doi-asserted-by":"publisher","DOI":"10.1227\/00006123-199606000-00011"},{"key":"e_1_2_11_4_2","doi-asserted-by":"publisher","DOI":"10.1007\/bf03009765"},{"key":"e_1_2_11_5_2","doi-asserted-by":"publisher","DOI":"10.3346\/jkms.2015.30.4.470"},{"key":"e_1_2_11_6_2","first-page":"772","article-title":"Cardiac Surgery Using CPB in Moyamoya Disease: A Case Report","volume":"36","author":"Lee G. B.","year":"2003","journal-title":"Korean J Thorac Cardiovasc Surg"},{"key":"e_1_2_11_7_2","doi-asserted-by":"publisher","DOI":"10.3349\/ymj.2007.48.5.876"},{"key":"e_1_2_11_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/s1569-9293(02)00100-7"},{"key":"e_1_2_11_9_2","doi-asserted-by":"publisher","DOI":"10.21037\/jtd.2016.02.67"},{"key":"e_1_2_11_10_2","doi-asserted-by":"publisher","DOI":"10.4103\/0971-9784.148323"},{"key":"e_1_2_11_11_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13256-015-0537-4"},{"key":"e_1_2_11_12_2","doi-asserted-by":"publisher","DOI":"10.1038\/jhg.2010.132"},{"key":"e_1_2_11_13_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamacardio.2024.1483"},{"key":"e_1_2_11_14_2","doi-asserted-by":"publisher","DOI":"10.5090\/jcs.20.058"},{"key":"e_1_2_11_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(09)70054-7"},{"key":"e_1_2_11_16_2","doi-asserted-by":"publisher","DOI":"10.1161\/strokeaha.111.622340"}],"container-title":["Case Reports in Anesthesiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1155\/cria\/3262548","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1155\/cria\/3262548","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1155\/cria\/3262548","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T04:54:15Z","timestamp":1779166455000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1155\/cria\/3262548"}},"subtitle":[],"editor":[{"given":"Manzo","family":"Suzuki","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2026,1]]},"references-count":16,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,1]]}},"alternative-id":["10.1155\/cria\/3262548"],"URL":"https:\/\/doi.org\/10.1155\/cria\/3262548","archive":["Portico"],"relation":{},"ISSN":["2090-6382","2090-6390"],"issn-type":[{"value":"2090-6382","type":"print"},{"value":"2090-6390","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1]]},"assertion":[{"value":"2026-03-05","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-04-29","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-18","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"3262548"}}