[A long-term result of coronary artery bypass on left coronary ostial stenosis secondary to Takayasu's disease: a case report].
A 37-year-old woman was admitted to our hospital for post operative coronary angiography. At the age of 17, she was diagnosed as having Takayasu's disease and at that time prednisolone was administered. At the age of 22, she was operated on to receive a coronary artery bypass graft (CABG) because of a 95% isolated stenosis in the left coronary ostium. Pathological specimen obtained from the ascending aorta demonstrated a proliferative stage of Takayasu's aortitis. After the CABG, she married and delivered two children, with the inflammation being kept under control by prednisolone. Coronary angiography performed 13 years after the operation proved the saphenous vein graft to the left anterior descending artery to be still patent. To our knowledge, this case has the longest history of a patent CABG used in an operation to correct the ostial stenosis secondary to Takayasu's disease. According to the previous reports we collected, the long-term patency rate of CABG is 78%, whereas that of ostial endarterectomy is unknown. Whether CABG or endarterectomy is better as an operating method for ostial stenosis due to aortitis is still a controversial point. We hope that reports of further examples will be available in order to help make the final decision.
Juntendo University Urayasu Hospital.
T
T
Kanoh
S
S
Kobayashi
O
O
Yamanaka
H
H
Kasuya
H
H
Ozaki
Y
Y
Wakiya
J
J
Amano
A
A
Suzuki
D000328:Adult; D001026:Coronary Artery Bypass; D003327:Coronary Disease / Q000209:etiology / Q000601:surgery*; D004691:Endarterectomy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D011379:Prognosis; D013625:Takayasu Arteritis / Q000150:complications*; D013997:Time Factors