title: Takayasu's arteritis with ostial and left main coronary artery stenosis.
abstract: 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.
authors.affiliation: P K Sen Department of Cardiovascular & Thoracic Surgery, King Edward Memorial Hospital and Seth G S Medical College, Mumbai 400012, India.
authors.forename: G Venkata Ramana
authors.initials: GV
authors.lastname: Kumar
authors.forename: N B
authors.initials: NB
authors.lastname: Agarwal
authors.forename: Satish
authors.initials: S
authors.lastname: Javali
authors.forename: Anil Madhav
authors.initials: AM
authors.lastname: Patwardhan
mesh_terms: 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