Repeat Operation for Pseudoaneurysm of Left Ventricular Outflow in a Patient with Concomitant Takayasu’s Arteritis and Marfan Syndrome

Abstract

We describe concomitant Marfan syndrome and Takayasu's arteritis complicating a pseudoaneurysm of the left ventricular outflow that developed after aortic root reconstruction. A patient was admitted with a high fever four months after initial root reconstruction that included valve sparing (reimplantation) as well as coronary artery reconstruction using a Carrel's button technique. Computed tomography revealed a pseudoaneurysm at the posterior side of the aortic root. We applied a modified Bentall procedure including coronary artery reconstruction using the Piehler technique. Pathological assessment of a specimen of the aorta revealed no central medial necrosis, but significant lymphocytic infiltration and thick fibrous adventitia indicating Takayasu's arteritis. This case was unique in terms of having simultaneous Takayasu's arteritis and cardiovascular manifestations of Marfan syndrome that were surgically treated.

Percutaneous Coronary Intervention for Interposed Coronary Graft Stenosis after Modified Bentall Procedure in a Teenaged Boy with Takayasu Arteritis

“…The most severe complication after the Bentall procedure for TA is dehiscence of the anastomotic site. 8,9 Our patient had undergone a repeat Bentall procedure to treat valved graft and interposed coronary graft detachment, which may have been related to active inf lammation associated with TA. Stenosis of the interposed graft may also have been caused in part by inf lammation.…”