CORONARY-ARTERY BYPASS-GRAFTING OF TAKAYASUS-DISEASE WITH CALCIFIED AORTA AND SUBCLAVIAN ARTERY OBSTRUCTION

The lesions of Takayasu's disease, which may involve the aorta and maj or arterial branches, may pose technical difficulties during coronary artery bypass grafting (CABG). Because the aorta is often thick and ca lcified, the coronary arterial lesion is often located near the corona ry orifice, and the internal thoracic arteries may not be suitable for grafting due to the lesions in the subclavian arteries. A 63-year-old man with a known history of Takayasu's disease was referred to our de partment with chest pain complaint. Coronary angiography revealed obst ruction of the left main coronary artery. CT scan showed that he had a thickened and calcified aorta. Aortography showed that both subclavia n arteries had obstructive disease, instead of using ordinary arterial grafts or vein grafts, a piece of prosthetic patch carrying saphenous vein grafts was sewn to the ascending aorta to construct the proximal anastomosis of CABG, Distal anastomosis was made on the left anterior descending artery and the obtuse marginal branch in the usual fashion , The patient showed uneventful recovery, and a postoperative coronary angiogram showed patent grafts and uncomplicated ventricular performa nce. This technique is useful when the aorta is not suitable for vein graft anastomosis and arterial grafts are not available as in this cas e with aortitis reported in the paper.