CASI CLINICI   

Chirurgia 2015 February;28(1):33-5

Copyright © 2015 EDIZIONI MINERVA MEDICA

lingua: Inglese

Coronary artery bypass grafting from splenic artery in Takayasu arteritis

Garcia M. V. F. ¹, Cordeiro R. A. ¹, Gaiotto F. A. ², Jatene F. B. ², Shinjo S. K. ³, Levy-Neto M. ³

¹ Internal Medicine Department, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil; ² Heart Institute, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil; ³ Department of Rheumatology, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil

The present report demonstrates that the splenic artery is an option as proximal blood source for saphenous vein grafts for surgical myocardial revascularization in Takayasu arteritis (TA). This idiopathic vasculitis affects mainly aorta and its major branches including coronary arteries. A coronary artery bypass grafting (CABG) should be considered when coronary involvement occurs, although, calcification of the vessels affected often makes them unsuitable for use. We report the case of 56 years-old woman who presented unstable angina and multiple arterial involvement, with severe coronary lesions. The patient underwent a CABG with splenic artery as proximal blood source. After surgery, angina was resolved, with good exertional tolerance for a 2 years follow-up period. The surgical treatment of symptomatic TA was effective and safe, showing that complex surgeries without extracorporeal circulation may be greatly beneficial for that group of patients. Symptomatic improvement and excellent long-term graft patency should be expected after arterial reconstruction.