Surgical Angioplasty For Left Coronary Ostial Stenosis in Takayasu's Disease -- A Case Report (original) (raw)

Takayasu's arteritis with ostial and left main coronary artery stenosis

Texas Heart Institute journal / from the Texas Heart Institute of St. Luke's Episcopal Hospital, Texas Children's Hospital, 2007

Takayasu's arteritis with coronary artery involvement is rare, and there is little published information on the subject. Coronary angiographic and histopathologic studies have revealed coronary artery lesions in 9% to 11% of cases. Coronary artery involvement consists mostly of stenosis or occlusion of the coronary ostia. We report the case of a 19-year-old woman who presented with crescendo angina. Upon investigation, we found that our patient had ostial and left main coronary arterial stenosis with left-dominant circulation; therefore, we decided that an arterial Y graft, performed on a beating heart, would provide better perfusion to the compromised myocardium than would a single graft to the left anterior descending artery. In addition, use of the Y graft obviated the need to perform a proximal anastomosis on an inflamed, edematous ascending aorta, and it conferred long-term graft patency of the internal mammary arteries. Timely coronary artery bypass grafting relieved our p...

Takayasu's Arteritis Involving the Ostia of Three Large Coronary Arteries

Korean circulation journal, 2009

Takayasu's arteritis can involve the ostia of coronary arteries. We report a patient with Takayasu's arteritis involving the ostia of three large coronary arteries who was successfully treated by percutaneous coronary intervention (PCI) with a drug-eluting stent (DES) and had a good clinical outcome after 12 months. A 37-year-old male with unstable angina was admitted to our cardiovascular center. The patient had Takayasu's arteritis and an aortic valve replacement with a metallic valve due to severe aortic regurgitation 7 years previously. Coronary angiography (CAG) showed a 95% discrete eccentric luminal narrowing at the ostia of the large left anterior descending (LAD) and left circumflex (LCX) arteries, and a 99% discrete eccentric luminal narrowing at the ostium of the large right coronary artery (RCA). The patient was treated with prednisolone for 14 days. Two large paclitaxel-eluting stents (PES) were then implanted in the distal left main coronary artery using th...

Left main trunk ostial stenosis and aortic incompetence in Takayasu's arteritis

Cardiovascular pathology : the official journal of the Society for Cardiovascular Pathology

A 41-year-old woman with recent onset of heart failure and angina due to aortic valve incompetence and critical left coronary ostium stenosis in the setting of Takayasu's arteritis is reported. The patient was successfully surgically treated by aortic valve replacement and coronary artery bypass with saphenous vein graft, showing a cardiac event-free 17 months follow-up. Takayasu's arteritis must be included among the possible causes of coronary artery disease and aortic valve incompetence in young female patients. Although chronic inflammation of the aortic wall may result in late graft occlusion, surgical therapy is effective for short and mid-term clinical improvement.

Percutaneous transluminal angioplasty in nonspecific aortoarteritis (Takayasu's disease): Experience of 16 cases

Cardiovascular and Interventional Radiology, 1989

Sixteen patients with aortoarteritis underwent percutaneous transluminal angioplasty for dilatation of 19 stenotic arteries. Sites included renal arteries (9), subclavian arteries (5), innominate artery (1), abdominal aorta (2), and descending thoracic aorta (2). Angiographic success was obtained in 14 lesions (74%) and partial success in 1 stenosis. The procedure was unsuccessful in 3 renal and 1 subclavian stenoses (21%). There were three complications. Clinically, there was cure of hypertension in three patients and improvement in six patients who had hypertension. Relief of claudication or return of pulsations was observed in seven patients. There was no evidence of any recurrence in the follow-up period (2–33 months). We conclude that percutaneous transluminal angioplasty is a safe and effective procedure for treating symptomatic stenotic lesions in aortoarteritis.

Severe ostial stenosis of the left coronary artery in 12-year-old girl as the first manifestation of Takayasu’s arteritis

Acta Cardiologica, 2009

We report the case of a 12-year-old girl who presented with isolated chest pain on minimal exertion over the last 2∞∞months. A coronary angiography revealed severe narrowing of the left coronary artery ostium and increased thickness of the ascending aortic wall was demonstrated by transoesophageal echocardiography, suggesting the diagnosis of Takayasu's arteritis.The patient was successfully treated with corticosteroids and coronary artery bypass graft surgery.

Surgical approach to left common carotid arterial dissection complicated during endovascular intervention in a patient with takayasu disease: Case report and review of literature

Turkish Journal of Vascular Surgery, 2019

Takayasu arteritis is a rare vasculitis of unknown etiology. Inflammation primarily involves aorta and its branches in this disease. In our case, multislice computerized tomographic angiography showed total occlusion of right, and critical stenosis of left internal carotid and proximal part of left subclavian arteries. A conventional angiography was planned to implant a stent to left internal carotid artery, and to screen any coronary lesions. There was osteal stenosis of left anterior descending artery (LAD) on coronary angiography. Takayasu arteritis was diagnosed regarding Ishikawa criteria, and the patient was administered corticosteroids. After 3 weeks of corticosteroid treatment, it was decided to implant a stent to LAD and left internal carotid artery. Although coronary intervention was successful, the carotid intervention with stent was unsuccessfully due to rupture of the intimal plaque. The patient was taken into operating room urgently due to stent failure. First, saphenous vein was prepared from upper segment of knee of left leg. However diameter of the vein was insufficient to be used as a vascular graft. Left internal carotid artery was reconstructed with a patch of saphenous vein. Additionally, a cross over bypass was performed from right common carotid artery to left common carotid artery using a 7 mm polytetrafluoroethylene graft over saphenous vein.