Successful management of left main coronary artery stenosis with a paclitaxel-eluting stent in Takayasu's arteritis (original) (raw)
Related papers
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...
Texas Heart Institute journal / from the Texas Heart Institute of St. Luke's Episcopal Hospital, Texas Children's Hospital, 2006
We describe the case of a young woman with Takayasu's arteritis that initially manifested as heart failure due to left main coronary artery stenosis. The patient's occluded subclavian artery and the active inflammatory process of Takayasu's arteritis precluded coronary artery bypass grafting with the use of arterial grafts. Therefore, a drug-eluting stent was placed in the unprotected left main artery. This procedure resulted in the resolution of symptoms, with a patent stent and no new coronary lesions observed on 3-month angiography, and normal left ventricular function on 9-month echocardiography. We conclude that the use of drug-eluting stents may be an important treatment option for Takayasu's arteritis patients with life-threatening coronary artery disease for whom coronary artery bypass grafting is not an option.
Left Main Coronary Occlusion from Takayasu Arteritis in an 8-Year-Old Child
Pediatric Cardiology, 2007
Takayasu's arteritis (TA) is a chronic systemic inflammatory disease that usually affects the aorta and its primary branches and occasionally the coronary arteries. We report the case of an 8-year-old girl who was presented with chest pain and was referred to our institution with the presumptive diagnosis of pneumonia and sepsis. Ultimately, the patient's chest pain was attributed to myocardial infarction secondary to coronary occulsion from TA. She underwent a successful stenting of the left main coronary artery with sirolimuseluting stent. In a review of the literature, we discuss the demographic profile, clinical and radiographic findings, and available therapeutic options.
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.
Surgical Angioplasty For Left Coronary Ostial Stenosis in Takayasu's Disease -- A Case Report
Vascular and Endovascular Surgery, 1992
Surgical angioplasty of the left main coronary artery for severe ostial stenosis in a thirty-five-year-old oriental woman suffering from Takayasu's disease was performed by use of an onlay autologous pericardial patch through an anterior aortotomy approach. This procedure was performed to reestablish a physiologic antegrade coronary arterial flow and to avoid use of internal mammary arteries, which have little flow in Takayasu's disease, or the saphenous veins, which can also be involved in the inflammatory process. The procedure also avoids a lengthy, time-consuming triple coronary artery bypass procedure and the use of saphenous veins, which are prone to certain slow or rapid attrition. Total clinical improvement with disappearance of angina and return of the patient to NYHA functional class I with normal treadmill exercise response was immediately obtained. Angiographic restudy six months after the surgical angioplasty revealed excellent results with complete wide patency of the ostium. This represents the first report in the world literature of surgical angioplasty of a left main coronary arterial ostial stenosis in Takayasu's disease.
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.