Coronary ostial plasty using femoral artery patch in Takayasu aortitis: A 15-year follow-up study.
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ABSTRACT:
SUBMITTER: Oishi K
PROVIDER: S-EPMC8302872 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:In ostial or proximal left main coronary artery (LMCA) obstruction, re-establishment of normal antegrade flow via the main trunk may be preferable to distal bypass grafting. The objective of this study was to assess the effectiveness of patch plasty of the left main (LM) trunk of the coronary artery for more than 10 years. Direct widening of the LMCA was recommended to patients with ostial, proximal, or midpoint stenosis of the main trunk. Group I of 16 patients had isolated LM obstruction with no distal disease, and Group II of 15 patients had, in addition, right coronary obstruction. The mean age was 60.9 years (age group, 47 to 83 years). Nineteen patients underwent this operation through an anterior transverse aortotomy. No endarterectomies were performed. In Group II, in addition, a single saphenous vein bypass graft was placed in the right coronary artery. There were no operative deaths. Follow-up period extends from 10 to 18 years (mean 11.2). Eight patients had angiography from 3 to 9 years after surgery and all show adequate LM trunk caliber. Noncardiac deaths occured in five patients (26.3%) at 2 months, and 1, 4, 6, and 7 years after surgery. Two women with isolated ostial stenosis diagnosed as a spasm have not shown progression of coronary disease 7 to 9 years after the operation. Widening of the LMCA should be considered in selective cases, only when ostial, proximal, or midportion stenosis of the main vessel exist, even if a right coronary bypass graft is required.
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Project description:Graphical abstract Highlights • Echocardiography is the first-line test to diagnose the presence and cause of AR.• Acute aortic syndromes should be excluded in patients with AR and a thickened aortic root.• Multimodal imaging with cardiac CT and MRI complement TTE and TEE to diagnose secondary causes of AR.• Aortitis is a potentially life-threatening disease, and is a rare cause of AR.
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Project description:This study was designed to evaluate ostial left main coronary artery (LMCA) stenosis and investigate concomitant stenotic lesions of LMCA and right coronary arteries (RCA) and their demographic and angiographic features. We evaluated 11,283 patients who underwent coronary angiography. Patients were placed into four groups according to having ostial or nonostial LMCA or RCA stenosis. Significant LMCA stenosis was observed in 242 (8.3%) of the patients, and only 68 (28.1%) of them had significant ostial LMCA stenosis. There was a significant correlation between ostial stenosis of LMCA and RCA (p = 0.03). The frequency of female gender was greater in ostial LMCA and ostial RCA stenosis groups compared with the other groups (p = 0.01). Ostial LMCA and RCA stenosis were related significantly. Both female predominance and coexistence of ostial LMCA and RCA stenosis might have suggest a different pathological ground for this disease.
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Project description:We report the case of a young woman with chest pain and recurrent abortion. The patient was found to have Takayasu arteritis. Drug therapy was started, and emergency bypass surgery was performed. The case showed the possible clinical manifestation of vasculitis as a recurrent abortion, followed by total occlusion of the left main coronary artery. (Level of Difficulty: Intermediate.).
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