Abstract
Takayasu’s arteritis is an inflammatory arteriopathy which involves the aorta and its major branches, causing mainly stenosis of their lumen, though aneurysmal lesions can also occur. A young female with Takayasu’s disease presented to our hospital with acute lung oedema due to severe aortic insufficiency and ascending aorta dilatation. She had already undergone distal ascending aorta and hemiarch replacement due to Standford type A aortic dissection five years ago. The patient had also undergone reconstruction of abdominal arteries’ stenoses with extraanatomical bypass. We performed a Bentall procedure with a valved conduit and implantation of the coronary ostia as buttons on the conduit. A mechanical valved graft was used instead of a bioprosthesis, due to possible early degradation of a bioprosthesis. The postoperative course was uneventful and the one year follow-up was normal. Valve-sparing aortic root replacement should be avoided in Takayasu’s arteritis due to high rate of recurrent regurgitation.
Highlights
Takayasu’s arteritis is an inflammatory arteriopathy which involves the aorta and its major branches, causing mainly stenosis of their lumen, though aneurysmal lesions can occur
We report a case of a young female with Takayasu’s disease presenting with ascending aorta dilatation and severe aortic insufficiency five years after distal ascending aorta replacement due to aortic dissection type A
Case presentation A 24 year-old Caucasian female was admitted to our hospital with acute pulmonary oedema due to severe aortic valve insufficiency
Summary
Takayasu’s arteritis is an inflammatory arteriopathy which involves the aorta and its major branches, causing mainly stenosis of their lumen, though aneurysmal lesions can occur. We report a case of a young female with Takayasu’s disease presenting with ascending aorta dilatation and severe aortic insufficiency five years after distal ascending aorta replacement due to aortic dissection type A. The patient was already diagnosed for Takayasu’s disease five years ago, as she was subjected to replacement of the distal ascending aorta and hemiarch because of acute aortic dissection type A. Later she was operated for stenosis of celiac artery and superior mesenteric artery, and stenosis of the orifices of both renal arteries, implying a relative aggressive form of the disease. The distal anastomosis of the composite graft with the old graft was performed with a running prolene suture. The one year clinical follow-up of the patient was remarkable with normal echocardiographical results and she was doing well in normal daily activities
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