Repeat Operation for Pseudoaneurysm of Left Ventricular Outflow in a Patient with Concomitant Takayasu’s Arteritis and Marfan Syndrome

• Published in: Annals of Vascular Diseases Vol. 4; no. 4; pp. 335 - 339
• Main Authors: Yamashiro, Satoshi, Kuniyoshi, Yukio, Arakaki, Katsuya, Nagano, Takaaki, Kise, Yuya
• Format: Journal Article
• Language: English
• Published: Japan The Editorial Committee of Annals of Vascular Diseases 01.01.2011; Japanese College of Angiology, The Japanese Society for Vascular Surgery, Japanese Society of Phlebology
• Subjects: aorta; Case Report; chronic inflammation; connective tissue disease; stenosis; aorta; stenosis; chronic inflammation; connective tissue disease
• ISSN: 1881-641X; 1881-6428
• DOI: 10.3400/avd.cr.11.00023

We describe concomitant Marfan syndrome and Takayasu’s arteritis complicating a pseudoaneurysm of the left ventricular outflow that developed after aortic root reconstruction. A patient was admitted with a high fever four months after initial root reconstruction that included valve sparing (reimplantation) as well as coronary artery reconstruction using a Carrel’s button technique. Computed tomography revealed a pseudoaneurysm at the posterior side of the aortic root. We applied a modified Bentall procedure including coronary artery reconstruction using the Piehler technique. Pathological assessment of a specimen of the aorta revealed no central medial necrosis, but significant lymphocytic infiltration and thick fibrous adventitia indicating Takayasu’s arteritis. This case was unique in terms of having simultaneous Takayasu’s arteritis and cardiovascular manifestations of Marfan syndrome that were surgically treated.