Bilateral coronary ostial patch angioplasty with autologous pericardium in Takayasu arteritis: a case requiring replacement of the aortic valve and ascending aorta.

Since the lesions and stages of Takayasu arteritis vary with each patient, surgical treatment of this disease requires meticulous planning for the timing of operation, technique, material used, and postoperative medication. We report a rare complex lesion of Takayasu arteritis, which required simultaneous repairs for aortic regurgitation, a dilated ascending aorta and bilateral coronary ostial stenosis. Such multiple lesions have not been reported previously. A 47-year-old woman was referred to us because of heart failure and chest pain. The coronary ostial stenosis were enlarged with generously sized autologous pericardial patches, and separate aortic valve and ascending aortic replacements were performed since the diameter of the Valsalva sinus was 37 mm. The postoperative course was uneventful, but steroid therapy was commenced postoperatively because inflammatory reaction remained high.