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ICVTS on-line discussion A

PSHC, King Fahd Medical City, Riyadh 11525, Saudi Arabia

Underestimated abdominal vascular pathology in a patient with Takayasu arteritis

eComment: I read with interest the paper entitled ‘Underestimated abdominal vascular pathology in a patient with Takayasu arteritis’ by Hartman et al. [1]. Takayasu arteritis is an idiopathic vasculitis that affects the aorta and its major branches. The disease starts as an active inflammation and progresses to a later sclerotic stage. This stage leads to obliterative luminal changes in the affected arteries. The changes are usually most marked at branch points. We published in the May issue of ICVTS a similar case report entitled ‘Coronary artery bypass grafting for Takayasu arteritis with severe coronary, carotid, subclavian, and renal artery invlolvement and subsequent pregnancy’ [2]. We totally agree with the conclusion by Hartman et al. that complete vascular work up and interventional or surgical treatment of asymptomatic but critical vascular lesions should be done considering the progressive and eventually obstructive luminal nature of the disease. Maintaining a higher mean arterial pressure during cardiopulmonary bypass and if possible using pulsatile flow will definitely reduce the vascular complications in this disease following cardiac surgery. Renal artery stenosis is commonly the cause for persistent, poorly controlled hypertension associated with Takayasu arteritis and properly leads to hypertensive heart failure as in the paper by Hartman et al. Renal angioplasty should be considered to prevent these complications.

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1. Hartman JM, Bekkers JA, Roos-Hesselink JW, Bogers AJJC. Underestimated abdominal vascular pathology in a patient with Takayasu arteritis. Interact CardioVasc Thorac Surg doi:10.1510/icvts.2006.129619.[Abstract/Free Full Text]
2. Khalaf HH, Arafa MR, Refaat AA, Ibrahim MF. Coronary artery bypass grafting for Takayasu arteritis with severe coronary, carotid, subclavian, and renal artery involvement and subsequent pregnancy. Interact CardioVasc Thorac Surg 2006; 5:153–155.[Abstract/Free Full Text]

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Mohamed Fahmy Ibrahim Permission Requests Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Ibrahim, M. F. Articles by Refaat, A. Search for Related Content PubMed PubMed Citation Articles by Ibrahim, M. F. Articles by Refaat, A. Related Collections Related Article