Takayasu’s Arteritis Mimicking Acute Aortic Dissection

• Published in: The Annals of thoracic surgery Vol. 83; no. 5; pp. 1876 - 1878
• Main Authors: Theodore, Sanjay, MCh, Vaidyanathan, Karthik, MS, Jagannath, Byalal Raghavendrarao, DNB, Nainar, MadhuSankar, DNB, Krishnamoorthy, Jaishankar, DM, Cherian, Kotturathu Mammen, FRACS
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.05.2007; Elsevier Science
• Subjects: Abscess - diagnosis; Adolescent; Aneurysm, Dissecting - diagnosis; Aortic Aneurysm - diagnosis; Aortic Valve Insufficiency - etiology; Aortic Valve Insufficiency - surgery; Biological and medical sciences; Blood and lymphatic vessels; Cardiology. Vascular system; Cardiothoracic Surgery; Coronary Stenosis - diagnosis; Coronary Stenosis - etiology; Coronary Stenosis - surgery; Diagnosis, Differential; Diseases of the aorta; Echocardiography, Transesophageal; Female; Heart Valve Prosthesis Implantation; Humans; Internal Mammary-Coronary Artery Anastomosis; Medical sciences; Sarcoidosis. Granulomatous diseases of unproved etiology. Connective tissue diseases. Elastic tissue diseases. Vasculitis; Surgery; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the heart; Surgery of the respiratory system; Takayasu Arteritis - complications; Takayasu Arteritis - diagnosis; Tomography, Spiral Computed; 26; Respiratory disease; Acute; Cardiovascular disease; Thorax; Differential diagnostic; Arterial disease; Vascular disease; Vasculitis; Treatment; Surgery; Systemic disease; Aortic dissection; Aortic disease; Takayashu arteritis
• ISSN: 0003-4975; 1552-6259
• DOI: 10.1016/j.athoracsur.2006.11.040

A 17-year-old girl presented with a history of dyspnea on exertion and fever of 1-week duration. She was evaluated elsewhere with transesophageal echocardiography and helical computed tomographic scan, and she had been diagnosed with an acute type I dissection of the aorta. She had also been diagnosed with severe aortic regurgitation and a suspected aortic root abscess. On the operating table, we found no evidence of dissection, but we did find that her aorta was severely thickened and inflamed. The patient’s aortic valve was replaced. In view of the left main stem ostial stenosis, we harvested and grafted the left internal thoracic artery to the left anterior descending artery. During the operation it is of paramount importance to rule out dissections involving the arch and coronary ostial narrowing.