Coronary Artery to Bronchial Artery Anastomosis in Takayasu’s Arteritis

Abstract

A 27-year-old woman presented with ischemia of the left arm and dizziness together with acute lateral wall myocardial ischemia. Physical examination showed narrowing of the arteries to the head and neck and upper limbs suggesting Takayasu’s arteritis. Angiography demonstrated pulmonary and systemic involvement. There was complete occlusion of the right upper lobe pulmonary artery and a large collateral artery from the circumflex coronary artery which anastomosed with the right bronchial artery. This anastomotic channel has not to our knowledge been described in Takayasu’s arteritis.

Takayasu Arteritis with Multiple Coronary Artery Fistulas to Bronchial Arteries

“…3 CFs in patients with TA have been reported between coronary arteries and pulmonary, bronchial or even intracranial arteries. [4][5][6] CF between pulmonary and coronary arteries have been found to be related to extensive pulmonary involvement. 7 The changes on the pulmonary vessels' wall have been found to be similar to those seen in systemic vessels and included inflammation with granulomatous lesions in the elastic, medial, and adventitial layers, often with thrombus formation with newly formed arterioles and small vessel dilatation.…”