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Takayasu's arteritis: surgical considerations.

R S Bloss, J M Duncan, D A Cooley

    The Annals of Thoracic Surgery
    |June 1, 1979
    PubMed
    Summary
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    Takayasu arteritis, a rare occlusive disease, can affect young men, presenting severe aortic arch involvement. Surgical bypass grafting offers successful revascularization for affected organ systems.

    Area of Science:

    • Cardiovascular Surgery
    • Vascular Surgery
    • Rheumatology

    Background:

    • Takayasu arteritis is a rare, idiopathic, chronic inflammatory condition affecting large arteries, primarily the aorta and its branches.
    • Historically, it was misperceived as exclusively affecting young women of Asian descent.
    • This case highlights the disease's potential to impact diverse demographics, including young men.

    Observation:

    • A 19-year-old male presented with severe stenosis of the aortic arch and its branches due to Takayasu arteritis.
    • The patient exhibited critical compromise of cerebral and visceral blood flow.
    • The right vertebral artery was identified as the sole patent vessel supplying the head.

    Findings:

    • Surgical intervention involved a bypass graft from the ascending aorta to the supraceliac abdominal aorta.

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  • Cerebral revascularization was achieved by extending a tube graft from the aortic bypass to the right vertebral artery distal to the stenosis.
  • This approach successfully restored blood flow to ischemic territories.

    • Implications:

    • Surgical bypass grafting using fabric conduits is a viable strategy for managing complex Takayasu arteritis.
    • This technique enables revascularization of ischemic organ systems and body areas, improving patient outcomes.
    • The findings challenge traditional perceptions of Takayasu arteritis demographics and underscore the importance of considering it in affected young men.