Zahra Hosseini.MD
Shahid rajaie cardiovascular medical and research center, tehran, Iran
Title: The Treatment Dilemma of Coronary Arteries Involvement in Patients with Takayasu Arteritis
Biography
Biography: Zahra Hosseini.MD
Abstract
Statement of the Problem: TA, is an inflammatory disease of unknown etiology which dominantly involved the aorta (pan-arteritis) from ascending to the abdominal aorta and the origin of the large vessels. Renal arteries, left subclavian artery, left carotid artery, innominate artery, and coronary arteries are predominantly compromised. Cardiac complications range between 10-30% including, the coronary ostial stenosis, aortic valve insufficiency, and myocarditis.2 The coronary lesions are classified as ostial stenosis, diffuse involvement or skip lesions, and aneurysm formation. Methodology & Theoretical Orientation: As the coronary arteries stenosis is associated with inflammation, intimal proliferation, and fibrous contraction, treatment of these patients is challenging; revascularization is highly suggested, particularly during inactive phase. According to the previous investigations, CABG is the preferred option; as the rate of stent restenosis is high (50% during 1 year). Also, as the diseased LSC, LIMA, and RIMA is frequent in these patients, vein graft is more desired. Findings: In this case report, we introduce, a 45 years TA patient, who was undergone AV repair and CABG 5 years ago; she presented with recent onset chest pain. Significant stenosis of the proximal anastomotic site of LIMA and the LSA were demonstrated. In this case, revascularization of LIMA proximal anastomotic site was performed antegradely. Conclusion & Significance: Regarding that the coronary artery disease in TA patients has a poor prognosis either by PCI or CABG, some new techniques are recommended to reduce the chance of stent or graft failure.