Critical left coronary main trunk stenosis, chronic occluded right coronary artery, left subclavian artery occlusion, severe aortic regurgitation and porcelain aorta in a patient with aortitis
Abstract Background Coronary involvement is rare but can be critical in patients with aortitis. Although cardiac ischemia can be resolved by coronary artery bypass grafting (CABG), patients complicated with cardiac ischemia, calcified aorta, and valve insufficiency pose difficult problems for surgeo...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
| Published: |
BMC
2020-09-01
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| Series: | Journal of Cardiothoracic Surgery |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s13019-020-01317-6 |
| _version_ | 1818273986144894976 |
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| author | Hideki Sasaki Takashi Harada Hiroshi Ishitoya Osamu Sasaki |
| author_facet | Hideki Sasaki Takashi Harada Hiroshi Ishitoya Osamu Sasaki |
| author_sort | Hideki Sasaki |
| collection | DOAJ |
| description | Abstract Background Coronary involvement is rare but can be critical in patients with aortitis. Although cardiac ischemia can be resolved by coronary artery bypass grafting (CABG), patients complicated with cardiac ischemia, calcified aorta, and valve insufficiency pose difficult problems for surgeons. Case presentation A 71-year-old woman was referred to our institution because of unstable angina. She had been previously diagnosed with aortitis and left subclavian artery occlusion. Contrast-enhanced computed tomography revealed severe left coronary main trunk stenosis, right coronary artery occlusion, and porcelain aorta. Ultrasonic echocardiogram showed severe aortic regurgitation. We performed emergent coronary artery bypass grafting, aortic valve replacement and ascending aorta replacement under hypothermic circulatory arrest. Conclusions The technique of circumferential calcified intimal removal and reinforcement with felt strips was effective for secure anastomosis. Unilateral cerebral perfusion from the right subclavian artery enabled good visualization and sufficient time to perform distal anastomosis. |
| first_indexed | 2024-12-12T22:06:40Z |
| format | Article |
| id | doaj.art-3d85771196c34e0a9c4acdc3cb9f4cf8 |
| institution | Directory Open Access Journal |
| issn | 1749-8090 |
| language | English |
| last_indexed | 2024-12-12T22:06:40Z |
| publishDate | 2020-09-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Cardiothoracic Surgery |
| spelling | doaj.art-3d85771196c34e0a9c4acdc3cb9f4cf82022-12-22T00:10:21ZengBMCJournal of Cardiothoracic Surgery1749-80902020-09-011511410.1186/s13019-020-01317-6Critical left coronary main trunk stenosis, chronic occluded right coronary artery, left subclavian artery occlusion, severe aortic regurgitation and porcelain aorta in a patient with aortitisHideki Sasaki0Takashi Harada1Hiroshi Ishitoya2Osamu Sasaki3Department of Cardiovascular Surgery, Ehime Prefectural Central HospitalDepartment of Cardiovascular Surgery, Ehime Prefectural Central HospitalDepartment of Cardiovascular Surgery, Ehime Prefectural Central HospitalDivision of Internal Medicine, Tokyo-Shinagawa HospitalAbstract Background Coronary involvement is rare but can be critical in patients with aortitis. Although cardiac ischemia can be resolved by coronary artery bypass grafting (CABG), patients complicated with cardiac ischemia, calcified aorta, and valve insufficiency pose difficult problems for surgeons. Case presentation A 71-year-old woman was referred to our institution because of unstable angina. She had been previously diagnosed with aortitis and left subclavian artery occlusion. Contrast-enhanced computed tomography revealed severe left coronary main trunk stenosis, right coronary artery occlusion, and porcelain aorta. Ultrasonic echocardiogram showed severe aortic regurgitation. We performed emergent coronary artery bypass grafting, aortic valve replacement and ascending aorta replacement under hypothermic circulatory arrest. Conclusions The technique of circumferential calcified intimal removal and reinforcement with felt strips was effective for secure anastomosis. Unilateral cerebral perfusion from the right subclavian artery enabled good visualization and sufficient time to perform distal anastomosis.http://link.springer.com/article/10.1186/s13019-020-01317-6Left coronary main trunk stenosisPorcelain aortaAortitis |
| spellingShingle | Hideki Sasaki Takashi Harada Hiroshi Ishitoya Osamu Sasaki Critical left coronary main trunk stenosis, chronic occluded right coronary artery, left subclavian artery occlusion, severe aortic regurgitation and porcelain aorta in a patient with aortitis Journal of Cardiothoracic Surgery Left coronary main trunk stenosis Porcelain aorta Aortitis |
| title | Critical left coronary main trunk stenosis, chronic occluded right coronary artery, left subclavian artery occlusion, severe aortic regurgitation and porcelain aorta in a patient with aortitis |
| title_full | Critical left coronary main trunk stenosis, chronic occluded right coronary artery, left subclavian artery occlusion, severe aortic regurgitation and porcelain aorta in a patient with aortitis |
| title_fullStr | Critical left coronary main trunk stenosis, chronic occluded right coronary artery, left subclavian artery occlusion, severe aortic regurgitation and porcelain aorta in a patient with aortitis |
| title_full_unstemmed | Critical left coronary main trunk stenosis, chronic occluded right coronary artery, left subclavian artery occlusion, severe aortic regurgitation and porcelain aorta in a patient with aortitis |
| title_short | Critical left coronary main trunk stenosis, chronic occluded right coronary artery, left subclavian artery occlusion, severe aortic regurgitation and porcelain aorta in a patient with aortitis |
| title_sort | critical left coronary main trunk stenosis chronic occluded right coronary artery left subclavian artery occlusion severe aortic regurgitation and porcelain aorta in a patient with aortitis |
| topic | Left coronary main trunk stenosis Porcelain aorta Aortitis |
| url | http://link.springer.com/article/10.1186/s13019-020-01317-6 |
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