Tanihata Akiko, Shibata Atsushi, Teragaki Kazutoshi, Yoshida Toshitake, Kitada Ryoko, Morisaki Akimasa, Ito Asahiro, Izumiya Yasuhiro, Fukuda Daiju
Department of Cardiovascular Medicine, Osaka Metropolitan University Graduate School of Medicine, Japan.
Department of Cardiovascular Surgery, Osaka Metropolitan University Graduate School of Medicine, Japan.
Intern Med. 2024 Oct 1;63(19):2641-2646. doi: 10.2169/internalmedicine.3032-23. Epub 2024 Feb 26.
We herein report the case of a 46-year-old woman with Takayasu arteritis (TA), severe stenosis in the left main coronary artery (LMCA), and severe aortic regurgitation. Prednisolone and tacrolimus were initiated as TA treatments. Two months after initiating medical therapy, the aortic regurgitation severity improved to a moderate grade, although there was no obvious improvement in LMCA stenosis. Thus, after confirming the resolution of inflammation, we performed coronary artery bypass grafting alone without any aortic valve intervention. In TA patients with severe LMCA stenosis, surgical management of the coronary artery should therefore be considered only after successfully administering anti-inflammatory therapy.
我们在此报告一例46岁患有高安动脉炎(TA)、左主干冠状动脉(LMCA)严重狭窄及严重主动脉瓣反流的女性病例。开始使用泼尼松龙和他克莫司进行TA治疗。开始药物治疗两个月后,主动脉瓣反流严重程度改善为中度,尽管LMCA狭窄无明显改善。因此,在确认炎症消退后,我们仅进行了冠状动脉旁路移植术,未进行任何主动脉瓣干预。因此,对于LMCA严重狭窄的TA患者,仅应在成功进行抗炎治疗后才考虑冠状动脉的手术治疗。