title: Anaortic Off-pump Coronary Artery Bypass Grafting in Patients with Takayasu's Arteritis.
abstract: BACKGROUND
  Coronary involvement in Takayasu's arteritis is a rare but fatal disease. The aim of this study was to evaluate the early and mid-term results of Takayasu's arteritis patients who underwent coronary artery bypass grafting (CABG).
  
  
  METHODS
  Of 2,280 patients who underwent isolated CABG from January 1998 to June 2012, Takayasu's arteritis was identified in 5 patients. There were 3 female patients, and the mean age was 58±9 years. Takayasu's arteritis was diagnosed during preoperative evaluation for coronary artery disease in 4 patients, and the initial manifestation was angina pectoris in 4 patients. All of the patients underwent anaortic off-pump CABG (OPCAB) using the in situ left or right internal thoracic arteries (ITA); 3 patients had severe stenosis of the proximal left subclavian artery and the in situ right ITA was used instead. Medical treatment for inflammatory arteritis during the perioperative and follow-up period was performed if indicated. Early, 1-year, and 5-year angiographic results and clinical outcomes were analyzed.
  
  
  RESULTS
  There was no surgical mortality, and all of the patients were discharged without complications on postoperative 8±2 days. Early postoperative (postoperative 2±1 days) angiography demonstrated a graft patency of 100% (12 of 12 distal anastomoses). One-year (13±3 months) angiography was performed in 4 patients, and all of the grafts were patent (100%, 9 of 9 distal anastomoses).
  
  
  CONCLUSIONS
  By performing anaortic OPCAB in patients with Takayasu's arteritis, we were able to avoid complications associated with manipulating an atherosclerotic and severely calcified ascending aorta. The early and mid-term graft patency of OPCAB in Takayasu's arteritis was maintained when concomitant with medical treatment.
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Korea.
authors.forename: Kwon Joong
authors.initials: KJ
authors.lastname: Na
authors.forename: Kyung-Hak
authors.initials: KH
authors.lastname: Lee
authors.forename: Se Jin
authors.initials: SJ
authors.lastname: Oh
authors.forename: Ho Young
authors.initials: HY
authors.lastname: Hwang
authors.forename: Ki-Bong
authors.initials: KB
authors.lastname: Kim
keywords: Coronary artery bypass surgery; Off-pump; Takayasu's arteritis