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

G Venkata Ramana Kumar1, N B Agarwal, Satish Javali

  • 1P K Sen Department of Cardiovascular & Thoracic Surgery, King Edward Memorial Hospital and Seth G S Medical College, Mumbai 400012, India.

Texas Heart Institute Journal
|January 4, 2008
PubMed

Insights

Takayasu arteritis can affect coronary arteries, causing stenosis. A Y-graft arterial bypass on a beating heart effectively treated a young woman with severe coronary ostial and left main stenosis, relieving her angina.

Area of Science:

  • Cardiology
  • Vascular Surgery
  • Rheumatology

Background:

  • Takayasu arteritis rarely involves coronary arteries, with lesions found in 9-11% of cases.
  • Coronary artery lesions typically manifest as ostial stenosis or occlusion.

Observation:

  • A 19-year-old woman presented with crescendo angina.
  • Diagnostic investigations revealed ostial and left main coronary arterial stenosis in a left-dominant circulation pattern.

Findings:

  • Arterial Y-graft bypass surgery on a beating heart was performed.
  • This approach provided superior myocardial perfusion compared to a single graft.
  • It avoided anastomosis to an inflamed aorta and ensured long-term internal mammary artery graft patency.

Implications:

  • Coronary artery bypass grafting is an effective treatment for Takayasu arteritis-induced coronary stenosis.
  • The Y-graft technique offers advantages in complex cases involving aortic inflammation.
  • Successful surgical intervention relieved angina and improved functional capacity in the patient.

Keywords:
Angina pectoris/etiology/surgeryTakayasu's arteritis/classification/complications/pathology/radiography/therapyaorta/pathologyarteritis/complicationscoronary angiographycoronary artery bypasscoronary disease/diagnosis/etiology/pathologycoronary stenosis/complications/surgerycoronary vessels/pathologyinternal mammary-coronary artery anastomosis/methodstreatment outcome

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