A successful surgical repair of pulmonary stenosis caused by isolated pulmonary Takayasu’s arteritis

• Published in: Heart and vessels Vol. 28; no. 2; pp. 264 - 267
• Main Authors: Fujita, Kishu, Nakashima, Kuniki, Kanai, Hiroyoshi, Kumakura, Hisao, Minami, Kazutomo
• Format: Journal Article
• Language: English
• Published: Japan Springer Japan 01.03.2013; Springer Nature B.V
• Subjects: Arterial Occlusive Diseases - diagnosis; Arterial Occlusive Diseases - etiology; Arterial Occlusive Diseases - physiopathology; Arterial Occlusive Diseases - surgery; Arterial Pressure; Biomedical Engineering and Bioengineering; Biopsy; Blood Vessel Prosthesis Implantation; Cardiac Surgery; Cardiology; Case Report; Constriction, Pathologic; Humans; Hypertension; Hypertension, Pulmonary - etiology; Male; Medicine; Medicine & Public Health; Middle Aged; Predictive Value of Tests; Pulmonary arteries; Pulmonary Artery - pathology; Pulmonary Artery - physiopathology; Pulmonary Artery - surgery; Takayasu Arteritis - complications; Takayasu Arteritis - diagnosis; Takayasu Arteritis - physiopathology; Takayasu Arteritis - surgery; Tomography, X-Ray Computed; Treatment Outcome; Vascular Surgery; Takayasu’s arteritis; Pulmonary surgical procedures; Pulmonary hypertension
• ISSN: 0910-8327; 1615-2573
• DOI: 10.1007/s00380-012-0262-5

A 48-year-old man underwent surgery to treat pulmonary stenoses of unknown origin. The right main pulmonary artery was severely stenotic, and the orifice of the left pulmonary artery was focally constricted. The patient was nearly asymptomatic, despite marked pulmonary hypertension and right heart strain. The pressure gradients beyond the stenotic regions were 88 mmHg bilaterally. The cause of the stenoses could not be established before operation. The right main pulmonary artery and ascending aorta were successfully replaced. It was suspected that the ascending aorta was involved because it was markedly thickened and adhered tightly to the right pulmonary artery. It was therefore also replaced. However, only the transected right pulmonary artery showed histological evidence consistent with a diagnosis of Takayasu’s arteritis. The postoperative course was uneventful. The patient was completely free of symptoms six months after the operation. To our knowledge, this is the thirteenth surgically treated case of isolated pulmonary Takayasu’s arteritis to be reported.