Angiographic findings and surgical treatments of coronary artery involvement in Takayasu arteritis
Angiographic findings and surgical treatments of coronary artery involvement in Takayasu arteritis
复制标题
DOI：
10.1067/mtc.2003.39
复制
发表时间：
2003-03-01
影响因子：
6
通讯作者：
Kasanuki, H
中科院分区：
文献类型：
--
作者：
Endo, M;Tomizawa, Y;Kasanuki, H
背景资料：多发性大动脉炎与冠状动脉受累（如狭窄、阻塞、动脉瘤和冠状动脉盗血综合征）的发生率低相关，但与冠状动脉缺血相关。可能是致命的。方法：自1972年至2001年4月，130例诊断为大动脉炎的患者中有81例接受了选择性冠状动脉造影，其中31例（4名男性和27名女性患者;平均年龄，41.1 ± 13.2岁）具有异常冠状动脉造影结果并被招募用于本研究。异常冠状动脉结果包括24支冠状动脉狭窄超过75%。冠状动脉-支气管动脉狭窄3例，冠状动脉扩张3例，冠状动脉扩张合并吻合1例。在24例冠状动脉狭窄患者中，开口部受累最多（87.5%）。24例冠状动脉狭窄患者中有23例接受了手术治疗。平均随访时间为9.65 ± 6.9年，随访率为100%。7例患者的4例瘘和4例动脉瘤未手术治疗。冠状动脉盗血现象常与肺动脉闭塞和肺动脉高压有关。动脉瘤性冠状动脉扩张与重度主动脉高压伴或不伴主动脉瓣返流和不典型缩窄有关。院内死亡2例（8.7%），晚期死亡3例（13%）。精算生存率，包括住院死亡，为86.5% +/- 7.3%，在5年和81.4% +/- 8.4%，在10 years.Conclusion：冠状动脉异常的发病率是相对较低的大动脉炎患者，但是，手术治疗建议冠状动脉口狭窄的患者，因为冠状动脉缺血可能是死亡的主要原因之一。
Background: Takayasu arteritis is associated with a low incidence of coronary artery involvement, such as stenosis, obstruction, aneurysm, and coronary steal syndrome, but coronary ischemia. can be fatal.Methods: Between 1972 and April 2001, 81 of 130 patients given a diagnosis of Takayasu arteritis underwent selective coronary an,angiography, and among them, 31 patients (4 male and 27 female patients; mean age, 41.1 +/- 13.2 years) had abnormal coronary angiographic findings and were recruited for this study.Results: Abnormal coronary findings consisted of 24 coronary artery stenoses of greater than 75%. 3 coronary artery-bronchial artery anastomoses, 3 aneurysmal coronary ectasias, and I combined coronary ectasia and anastomosis. Among 24 patients with coronary stenosis, the ostium was most frequently involved (87.5%). Twenty-three of 24 patients with coronary artery stenoses were treated surgically. The mean follow-up duration was 9.65 +/- 6.9 years, with a 100% follow-up rate. Four fistulas and 4 aneurysms in 7 patients were not treated surgically. Coronary steal phenomenon was always associated with occluded pulmonary arteries and pulmonary hypertension. Aneurysmal coronary ectasia was related to severe aortic hypertension with or without aortic regurgitation and atypical coarctation. There were 2 (8.7%) in-hospital deaths and 3 C (13%) late deaths. The actuarial survival rate, including in-hospital deaths, was 86.5% +/- 7.3% at 5 years and 81.4% +/- 8.4% at 10 years.Conclusion: The incidence of coronary abnormalities is relatively low in patients with Takayasu arteritis; however, surgical treatment is recommended for patients with coronary ostial stenoses because coronary ischemia can be one of the major causes of death.