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CURRENT ISSUETHE JOURNAL OF CARDIOVASCULAR SURGERY

A Journal on Cardiac, Vascular and Thoracic Surgery


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CASE REPORTS  CARDIAC SECTION


The Journal of Cardiovascular Surgery 2002 October;43(5):647-9

language: English

Giant cell arteritis confined to intramural coronary arteries. Unforeseen hazards myocardial protection

Kumar P. 1, Velissaris T. 1, Sheppard M. N. 2, Pepper J. R. 1

1 Depart­ment of Car­diac Sur­gery
2 Pathology, ­Royal ­Brompton Hos­pital, ­London, UK


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A 74-­year-old ­woman under­went elec­tive ­double ­valve replace­ment (­aortic and ­mitral) for rheu­matic val­vular dis­ease. She ­failed to ­wean ­from car­di­o­pul­mo­nary ­bypass due to ­marked ­left ven­tric­ular dys­func­tion. At ­autopsy, ­severe ­giant ­cell arter­itis con­fined to the intra­mural cor­o­nary ­arteries was ­seen. Fur­ther­more, ­there ­were mul­tiple ­areas of ­recent micro­scopic myo­car­dial infarc­tion ­around the intra­mural cor­o­nary ­arteries. ­This ­report ­describes a ­rare ­case of ­giant ­cell arter­itis con­fined to intra­mural cor­o­nary ­arteries ­which ­lead to inad­e­quate myo­car­dial pro­tec­tion at the ­time of sur­gery.

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