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Repeat Revascularization for Severe Recurrent Coronary Artery Disease in a Young Woman With Takayasu Arteritis

Mahesh V Madhavan1,2, Ellie J Coromilas1, Timothy J Poterucha1

  • 1Department of Medicine, Division of Cardiology, NewYork-Presbyterian Hospital/Columbia University Irving Medical Center, New York, New York.

JACC. Case Reports
|July 28, 2021
PubMed

Insights

Takayasu arteritis can cause acute coronary syndrome in young women. Successful treatment involved coronary artery bypass surgery followed by percutaneous coronary intervention for graft failure.

Area of Science:

  • Cardiovascular Medicine
  • Rheumatology
  • Vascular Surgery

Background:

  • Takayasu arteritis is a rare, large-vessel vasculitis affecting the aorta and its branches.
  • Coronary artery involvement, particularly ostial left main stenosis, is a serious complication.
  • Acute coronary syndrome (ACS) in young adults warrants thorough investigation for underlying inflammatory conditions.

Observation:

  • A young female patient with a diagnosis of Takayasu arteritis presented with symptoms of ACS.
  • Initial evaluation revealed ostial left main coronary artery stenosis.
  • The patient underwent urgent coronary artery bypass grafting (CABG).

Findings:

  • Recurrent ischemic symptoms developed six months post-CABG due to graft failure.
  • Percutaneous coronary intervention (PCI) was successfully performed to address the graft issue.
  • The patient experienced symptom resolution following PCI.

Implications:

  • This case highlights the importance of considering Takayasu arteritis in young patients with ACS and coronary stenosis.
  • It underscores the potential for graft failure after CABG in vasculitis patients.
  • It demonstrates the efficacy of PCI as a treatment option for managing graft complications in this population.

Keywords:
CABG, coronary artery bypass graftingDES, drug-eluting stentLAD, left anterior descending coronary arteryLIMA, left internal mammary arteryLMCA, left main coronary arteryPCI, percutaneous coronary interventionRCA, right coronary arteryRIMA, right internal mammary arterySVG, saphenous vein graftcoronary artery bypasspercutaneous coronary interventionvascular disease

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