CASE REPORTS  CARDIAC SECTION 

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

Copyright © 2009 EDIZIONI MINERVA MEDICA

lingua: Inglese

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

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.