Takayasu arteritis with multiple cardiovascular complications |
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Authors: | A Nishiyama S Matsubara J Toyama |
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Institution: | (1) Department of Cardiology, Shinshiro Municipal Hospital, Shinshiro, Japan, JP;(2) Department of Cardiology, Aichi Prefecture Owari Hospital, Ichinomiya, Japan, JP |
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Abstract: | A 60-year-old Japanese woman first presented in 1990 with effort angina. She underwent coronary angiography and was diagnosed
with bilateral coronary ostial stenosis and Takayasu arteritis. Coronary artery bypass graft surgery (CABG) for multiple vessels
was attempted, but the blood flow in the bilateral internal thoracic and gastroepiploic arteries was to poor for a donor artery,
and the calcification of the ascending aortic wall was too severe for anastomosis of saphenous vein grafts. Therefore, the
proper hepatic artery was connected to the left anterior descending artery using a vein graft. In April 2000, the patient's
angina worsened. Occlusions of both subclavian arteries, bilateral coronary ostial stenosis and vein graft occlusion, aortic
valve regurgitation, and two severe stenoses of the descending aorta were observed. Aortic valve replacement, and coronary
and aorta revascularization were desirable, but the severe aortic wall calcification and thickening rendered these interventions
impossible. Treatment with medication was chosen. The patient was discharged without severe angina. A combination of these
serious cardiovascular complications which do not allow any surgical intervention is very rare.
Received: May 21, 2001 / Accepted: August 24, 2001 |
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Keywords: | Takayasu arteritis Coronary artery bypass graft Aortic stenosis Blood pressure |
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