title: Simultaneous repair of stenosis in coronary and vertebral arteries and aortic regurgitation secondary to Takayasu's aortitis.
abstract: We report a case of severe stenosis in the ostium of both the coronary artery and the proximal left vertebral artery and severe aortic regurgitation secondary to Takayasu's aortitis. A 47-year-old woman underwent simultaneous repair consisting of aortic valve replacement, triple coronary artery bypass grafting, and aorto-left vertebral artery bypass. Saphenous vein grafts to 3 coronary arteries and the left vertebral artery were proximally anastomosed on a bovine pericardial patch in the ascending aorta. Since the patient had severe preoperative ischemic symptoms from vertebral-basilar insufficiency, we clamped the vertebral artery during reconstruction under deep hypothermic circulation. The postoperative course was uncomplicated. Simultaneous repair of such multiple lesions requires meticulous planning of surgical procedures and circulatory assist systems.
authors.affiliation: Division of Cardiovascular Surgery, Department of Surgery, Course of Interventional Medicine (E1), Osaka University Graduate School of Medicine, 2-2 Yamada-oka, Suita, Osaka 565-0871, Japan.
authors.forename: Goro
authors.initials: G
authors.lastname: Matsumiya
authors.forename: Shigeaki
authors.initials: S
authors.lastname: Ohtake
authors.forename: Yoshiki
authors.initials: Y
authors.lastname: Sawa
authors.forename: Tohru
authors.initials: T
authors.lastname: Ishizaka
authors.forename: Toshiki
authors.initials: T
authors.lastname: Yoshimine
authors.forename: Hikaru
authors.initials: H
authors.lastname: Matsuda
mesh_terms: D000714:Anastomosis, Surgical; D000818:Animals; D001011:Aorta / Q000601:surgery; D001022:Aortic Valve Insufficiency / Q000209:etiology* / Q000601:surgery*; D002315:Cardiopulmonary Bypass; D002417:Cattle; D002548:Cerebral Revascularization; D001026:Coronary Artery Bypass; D023921:Coronary Stenosis / Q000209:etiology* / Q000601:surgery*; D005260:Female; D006324:Heart Arrest, Induced; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D008875:Middle Aged; D012501:Saphenous Vein / Q000637:transplantation; D013625:Takayasu Arteritis / Q000150:complications*; D016896:Treatment Outcome; D014711:Vertebral Artery / Q000601:surgery; D014715:Vertebrobasilar Insufficiency / Q000209:etiology* / Q000601:surgery*