A Case of Takayasu's Arteritis with Aortic Root Abscess after AVR and during Biologic Drug Administration
- VernacularTitle:AVR後，生物学的製剤投与中に弁輪部膿瘍を生じた高安動脈炎の1例
- Author:
Shinji KAWAGUCHI
1
;
Masanao NAKAI
1
;
Takahiro OZAWA
1
;
Daisuke UCHIYAMA
1
;
Yuta MIYANO
1
;
Yasuhiko TERAI
1
;
Muneaki YAMADA
1
;
Ryota NOMURA
1
;
Hiroshi MITSUOKA
1
Author Information
- Keywords: Takayasu's arteritis; Tocilizumab; pseudoaneurysm of the aortic root
- From:Japanese Journal of Cardiovascular Surgery 2024;53(2):66-69
- CountryJapan
- Language:Japanese
- Abstract: A 32-year-old woman was diagnosed with Takayasu's arteritis 5 years ago and underwent aortic valve replacement for aortic regurgitation 1 year ago. She had been taking Prednisolone and Azathioprine for Takayasu's arteritis, but these drugs were switched to subcutaneous Tocilizumab 4 months ago. One month ago, she had dyspnea on exertion, and 2 days ago, chest discomfort appeared, and she came to our hospital. Blood tests showed CRP 0.02 mg/dl, and echocardiography and CT showed perivalvular leakage and aortic root pseudoaneurysm, which led us to suspect aortic root pseudoaneurysm due to Takayasu's arteritis and to perform emergency surgery. Although a circumferential pseudoaneurysm was observed at the aortic root, no destruction of the prosthetic valve was observed. The suture from the previous surgery was attached to the sawing cuff of the prosthetic valve, and the prosthetic valve was not fixed to the aortic annulus and could be easily removed. The Bentall operation was performed using a bioprosthetic valve. The histopathological diagnosis was subacute infective endocarditis, and the patient was diagnosed with a pseudoaneurysm of the aortic root due to infection. The patient had a good postoperative course and was discharged home on the 19th day. We report a case of Takayasu's arteritis with valve annular abscess after AVR, which was treated surgically during biologic drug administration.
