Anaortic Off-pump Coronary Artery Bypass Grafting in Patients with Takayasu's Arteritis.
- Author:
Kwon Joong NA
1
;
Kyung Hak LEE
;
Se Jin OH
;
Ho Young HWANG
;
Ki Bong KIM
Author Information
1. Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Korea. kimkb@snu.ac.kr
- Publication Type:Original Article
- Keywords:
Takayasu's arteritis;
Coronary artery bypass surgery;
Off-pump
- MeSH:
Angina Pectoris;
Angiography;
Aorta;
Arteritis;
Constriction, Pathologic;
Coronary Artery Bypass;
Coronary Artery Bypass, Off-Pump;
Coronary Artery Disease;
Female;
Follow-Up Studies;
Humans;
Mammary Arteries;
Subclavian Artery;
Takayasu Arteritis;
Transplants
- From:The Korean Journal of Thoracic and Cardiovascular Surgery
2013;46(4):274-278
- CountryRepublic of Korea
- Language:English
-
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). MATERIALS AND 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). CONCLUSION: 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.
