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Coronary artery bypass grafting in Takayasu’s disease – importance of the proximal anastomosis: a case report

INTRODUCTION: Treatment of coronary artery involvement in Takayasu’s arteritis is challenging. Coronary artery bypass grafting may be required. The use of saphenous vein grafts is recommended because of possible inflammatory involvement of the internal thoracic arteries. However, inserting the proxi...

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Autores principales: Kuijer, Anne, van Oosterhout, Matthijs F. M., Kloppenburg, Geoffrey T. L., Morshuis, Wim J.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4678760/
https://www.ncbi.nlm.nih.gov/pubmed/26666882
http://dx.doi.org/10.1186/s13256-015-0767-5
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author Kuijer, Anne
van Oosterhout, Matthijs F. M.
Kloppenburg, Geoffrey T. L.
Morshuis, Wim J.
author_facet Kuijer, Anne
van Oosterhout, Matthijs F. M.
Kloppenburg, Geoffrey T. L.
Morshuis, Wim J.
author_sort Kuijer, Anne
collection PubMed
description INTRODUCTION: Treatment of coronary artery involvement in Takayasu’s arteritis is challenging. Coronary artery bypass grafting may be required. The use of saphenous vein grafts is recommended because of possible inflammatory involvement of the internal thoracic arteries. However, inserting the proximal anastomosis on inflamed aortic tissue may give rise to stenosis. Only a few cases of inserting a proximal anastomosis in patients with Takayasu’s arteritis have been reported in the literature. To date, no consensus has been reached on the best way to perform this procedure in patients with Takayasu’s arteritis. CASE PRESENTATION: We report a case of a 25-year-old white woman with Takayasu’s arteritis who had recurrent angina after two previous treatments had failed, due to left main stem stenosis. She was successfully treated by coronary artery bypass grafting using a Dacron patch to insert the proximal anastomosis. CONCLUSIONS: We are the first to report an uncomplicated case in which a Dacron (Vascutek®, Renfrewshire) prosthetic patch was used to insert the proximal anastomosis on an inflamed aorta in a patient with Takayasu’s arteritis. The patch prevents contact between inflamed tissue and the graft, which we believe reduces the risk of graft failure. This case might inspire other thoracic surgeons in the challenging task of performing revascularization techniques in patients with an inflamed and fragile aorta.
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spelling pubmed-46787602015-12-16 Coronary artery bypass grafting in Takayasu’s disease – importance of the proximal anastomosis: a case report Kuijer, Anne van Oosterhout, Matthijs F. M. Kloppenburg, Geoffrey T. L. Morshuis, Wim J. J Med Case Rep Case Report INTRODUCTION: Treatment of coronary artery involvement in Takayasu’s arteritis is challenging. Coronary artery bypass grafting may be required. The use of saphenous vein grafts is recommended because of possible inflammatory involvement of the internal thoracic arteries. However, inserting the proximal anastomosis on inflamed aortic tissue may give rise to stenosis. Only a few cases of inserting a proximal anastomosis in patients with Takayasu’s arteritis have been reported in the literature. To date, no consensus has been reached on the best way to perform this procedure in patients with Takayasu’s arteritis. CASE PRESENTATION: We report a case of a 25-year-old white woman with Takayasu’s arteritis who had recurrent angina after two previous treatments had failed, due to left main stem stenosis. She was successfully treated by coronary artery bypass grafting using a Dacron patch to insert the proximal anastomosis. CONCLUSIONS: We are the first to report an uncomplicated case in which a Dacron (Vascutek®, Renfrewshire) prosthetic patch was used to insert the proximal anastomosis on an inflamed aorta in a patient with Takayasu’s arteritis. The patch prevents contact between inflamed tissue and the graft, which we believe reduces the risk of graft failure. This case might inspire other thoracic surgeons in the challenging task of performing revascularization techniques in patients with an inflamed and fragile aorta. BioMed Central 2015-12-15 /pmc/articles/PMC4678760/ /pubmed/26666882 http://dx.doi.org/10.1186/s13256-015-0767-5 Text en © Kuijer et al. 2015 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Case Report
Kuijer, Anne
van Oosterhout, Matthijs F. M.
Kloppenburg, Geoffrey T. L.
Morshuis, Wim J.
Coronary artery bypass grafting in Takayasu’s disease – importance of the proximal anastomosis: a case report
title Coronary artery bypass grafting in Takayasu’s disease – importance of the proximal anastomosis: a case report
title_full Coronary artery bypass grafting in Takayasu’s disease – importance of the proximal anastomosis: a case report
title_fullStr Coronary artery bypass grafting in Takayasu’s disease – importance of the proximal anastomosis: a case report
title_full_unstemmed Coronary artery bypass grafting in Takayasu’s disease – importance of the proximal anastomosis: a case report
title_short Coronary artery bypass grafting in Takayasu’s disease – importance of the proximal anastomosis: a case report
title_sort coronary artery bypass grafting in takayasu’s disease – importance of the proximal anastomosis: a case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4678760/
https://www.ncbi.nlm.nih.gov/pubmed/26666882
http://dx.doi.org/10.1186/s13256-015-0767-5
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