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Sustitución concomitante de la raíz pulmonar y de la raíz aórtica para la arteritis de células gigantes

Joshua R Chen¹, Bradley Taylor¹, Aakash Shah¹

¹Division of Cardiac Surgery, Department of Surgery, University of Maryland, Baltimore, MD, USA

Multimedia manual of cardiothoracic surgery : MMCTS

|September 1, 2025

Resumen

La arteritis de células gigantes rara vez causa aneurismas aórticos y de raíz pulmonar simultáneos. Este caso destaca el reemplazo exitoso de la válvula aórtica y pulmonar con la reparación de la válvula tricúspide en un paciente con esta rara afección.

Área de la Ciencia:

Cirugía cardiovascular
Reumatología
Medicina vascular

Sus antecedentes:

La arteritis de células gigantes (GCA) es una vasculitis sistémica que afecta principalmente a las arterias medianas y grandes.
Los aneurismas de las raíces aórticas y pulmonares son manifestaciones poco frecuentes de GCA.
Los aneurismas concomitantes en las raíces aórticas y pulmonares debidos al GCA son excepcionalmente raros.

Objetivo del estudio:

Para reportar un raro caso de aneurisma aórtico y pulmonar secundario a una arteritis de células gigantes.
Para describir el manejo quirúrgico de esta presentación compleja.
Para enfatizar la importancia de considerar la GCA en pacientes con dilatación inexplicable de la raíz aórtica y pulmonar.

Principales métodos:

Un caso de presentación de un paciente diagnosticado con arteritis de células gigantes.
Intervención quirúrgica que involucra el reemplazo concomitante de la raíz aórtica conservadora de válvulas (VSARR) y el reemplazo de la raíz pulmonar conservadora de válvulas (VSPRR).
La reparación simultánea de la válvula tricúspide se realizó durante la misma sesión quirúrgica.

Principales resultados:

Se logró una VSARR y VSPRR simultáneas exitosas.
La reparación de la válvula tricúspide se completó con éxito.
El paciente toleró bien el complejo procedimiento quirúrgico, sin reportar complicaciones inmediatas.

Conclusiones:

La arteritis de células gigantes puede conducir a complicaciones cardiovasculares raras pero graves, incluidos los aneurismas concomitantes de la raíz aórtica y pulmonar.
Las técnicas de ahorro de válvulas para las raíces aórticas y pulmonares son factibles en casos selectos de GCA.
El manejo multidisciplinario que involucra reumatología y cirugía cardiotorácica es crucial para obtener resultados óptimos en los pacientes.

Palabras clave:

Reparación de la válvula aórtica Cirugía de la arteria pulmonar Ahorro de válvulas

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