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Idhrees et al. Vessel Plus 2020;4:23 Vessel Plus
DOI: 10.20517/2574-1209.2020.15

Review Open Access

Management of cardiac manifestations in Takayasu
arteritis

Mohammed Idhrees , Nambi Thilagavathi , Mohamad Bashir , Bashi V. Velayudhan 1
3
1,2
1
1 Institute of Cardiac and Aortic Disorders, SIMS Hospital, Chennai 600026, India.
2 Consultant, Department of Rheumatology, SIMS Hospital, Chennai 600026, India.
3 Department of Vascular & Endovascular Surgery, Royal Blackburn Teaching Hospital, Blackburn BB2 3HH, United Kingdom.
Correspondence to: Dr. Mohammed Idhrees, Cardiovascular Surgeon, Institute of Cardiac and Aortic Disorders, SRM Institutes
for Medical Science (SIMS Hospital), Chennai 600026, India. E-mail: a.m.idhrees@gmail.com
How to cite this article: Idhrees M, Thilagavathi N, Bashir M, Velayudhan BV. Management of cardiac manifestations in Takayasu
arteritis. Vessel Plus 2020;4:23. http://dx.doi.org/10.20517/2574-1209.2020.15
Received: 11 May 2020 First Decision: 22 Jun 2020 Revised: 7 Jul 2020 Accepted: 10 Jul 2020 Published: 15 Aug 2020

Academic Editor: Cristiano Spadaccio Copy Editor: Cai-Hong Wang Production Editor: Jing Yu

Abstract
Received: First Decision: Revised: Accepted: Published: x
Takayasu arteritis (TA) is a chronic vasculitis involving large vessels of unknown aetiology, a disease that is
Science Editor: Copy Editor: Production Editor: Jing Yu more common among the Asian population and predominant in young women. Cardiac manifestations include
hypertension and involvement of the cardiac valves, myocardium and coronary arteries. Surgery on these patients
is always a challenge given the tissue quality and the disease activity. They are prone to long-term complications
such as restenosis and graft occlusion, hence requiring lifelong surveillance. The prevalence of coronary artery
disease (CAD) in TA ranges from 9 to 11%. Coronary artery bypass grafting is preferred to percutaneous coronary
intervention, as the latter has a high rate of restenosis and major adverse cardiovascular events. As left subclavian
artery is commonly involved, saphenous vein graft is advised as a conduit rather than internal mammary artery.
Other surgical procedures described for CAD are surgical angioplasty of the left main coronary artery and
transaortic coronary ostial endarterectomy. Aortic regurgitation in TA has an incidence of approximately 20%.
These patients tend to have prosthetic valve detachment, paravalvular leak or pseudoaneurysm at the anastomotic
site. Further repair of these valves have a high rate of failure. Considering these facts, it is advisable to do an aortic
root replacement for TA patients than to consider an aortic valve replacement or David's procedure.

Keywords: Takayasu arteritis, coronary artery, aortic valve, myocarditis, ascending aorta, aortoarteritis, pulmonary
arteritis

© The Author(s) 2020. Open Access This article is licensed under a Creative Commons Attribution 4.0
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