Popis: |
Takayasu's arteritis with coronary artery involvement is rare, and there is little published information on the subject. Coronary angiographic and histopathologic studies have revealed coronary artery lesions in 9% to 11% of cases. Coronary artery involvement consists mostly of stenosis or occlusion of the coronary ostia. We report the case of a 19-year-old woman who presented with crescendo angina. Upon investigation, we found that our patient had ostial and left main coronary arterial stenosis with left-dominant circulation; therefore, we decided that an arterial Y graft, performed on a beating heart, would provide better perfusion to the compromised myocardium than would a single graft to the left anterior descending artery. In addition, use of the Y graft obviated the need to perform a proximal anastomosis on an inflamed, edematous ascending aorta, and it conferred long-term graft patency of the internal mammary arteries. Timely coronary artery bypass grafting relieved our patient's angina, and in early follow-up she has shown good effort tolerance. |