Takayasu's arteritis with ostial and left main coronary artery stenosis.
Takayasu's arteritis with coronary artery involvement is rare, and there is little published information on the subject. Coronary angiographic and histopathologic studies have revealed coronary artery lesions in 9% to 11% of cases. Coronary artery involvement consists mostly of stenosis or occlusion of the coronary ostia. We report the case of a 19-year-old woman who presented with crescendo angina. Upon investigation, we found that our patient had ostial and left main coronary arterial stenosis with left-dominant circulation; therefore, we decided that an arterial Y graft, performed on a beating heart, would provide better perfusion to the compromised myocardium than would a single graft to the left anterior descending artery. In addition, use of the Y graft obviated the need to perform a proximal anastomosis on an inflamed, edematous ascending aorta, and it conferred long-term graft patency of the internal mammary arteries. Timely coronary artery bypass grafting relieved our patient's angina, and in early follow-up she has shown good effort tolerance.
Kumar
G Venkata Ramana
GV
P K Sen Department of Cardiovascular & Thoracic Surgery, King Edward Memorial Hospital and Seth G S Medical College, Mumbai 400012, India.
Agarwal
N B
NB
Javali
Satish
S
Patwardhan
Anil Madhav
AM
D000328:Adult; D001027:Aortography; D017023:Coronary Angiography; D001026:Coronary Artery Bypass / Q000379:methods; D023921:Coronary Stenosis / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D012720:Severity of Illness Index; D013625:Takayasu Arteritis / Q000150:complications* / Q000000981:diagnostic imaging