Coronary artery bypass grafting in Takayasu's disease - Importance of the proximal anastomosis: A case report

被引：9
作者：
Kuijer A. [1 ]
Van Oosterhout M.F.M. [2 ]
Kloppenburg G.T.L. [3 ]
Morshuis W.J. [3 ]
机构：
[1] Department of Surgery, Diakonessenhuis Utrecht, Bosboomstraat 1, P.O. Box 80250, Utrecht
[2] Department of Pathology, Sint Antonius Hospital Nieuwegein, Koekoekslaan 1, mailbox 2500, Nieuwegein
[3] Department of Cardiothoracic Surgery, Sint Antonius Hospital Nieuwegein, Koekoekslaan 1, mailbox 2500, Nieuwegein
来源：
Journal of Medical Case Reports | / 9卷 / 1期
关键词：
Coronary artery bypass graft; Coronary artery disease; Proximal anastomosis; Takayasu's arteritis; Venous grafts;
D O I：
10.1186/s13256-015-0767-5
中图分类号：
学科分类号：
摘要：
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. © 2015 Kuijer et al.
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