Severe Left Main Coronary Artery Stenosis and Aortic Regurgitation in a Patient Presenting with Takayasu Arteritis

• Published in: Internal Medicine 2024/10/01, Vol.63(19), pp.2641-2646
• Main Authors: Tanihata, Akiko, Shibata, Atsushi, Teragaki, Kazutoshi, Yoshida, Toshitake, Kitada, Ryoko, Morisaki, Akimasa, Ito, Asahiro, Izumiya, Yasuhiro, Fukuda, Daiju
• Format: Article
• Language: English
• Subjects: anti-inflammatory therapy; Aortic valve; Aortic Valve Insufficiency - diagnosis; Aortic Valve Insufficiency - etiology; Aortic Valve Insufficiency - surgery; Arteritis; Case Report; Coronary artery; Coronary Artery Bypass; coronary artery bypass grafting; coronary artery disease; Coronary Stenosis - complications; Coronary Stenosis - diagnostic imaging; Coronary Stenosis - etiology; Coronary Stenosis - surgery; Female; Humans; Middle Aged; Prednisolone; Prednisolone - therapeutic use; Regurgitation; Severity of Illness Index; Stenosis; Tacrolimus; Takayasu arteritis; Takayasu Arteritis - complications; Takayasu Arteritis - diagnosis; Takayasu Arteritis - diagnostic imaging; Takayasu's disease
• ISSN: 0918-2918; 1349-7235; 1349-7235
• DOI: 10.2169/internalmedicine.3032-23

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.