Pulmonary Artery Involvement in Takayasu's Arteritis

Eulo, Lupi H.; Gustavo, Sánchez T.; Horwitz, S; Efrén, Gutierrez F.

doi:10.1378/chest.67.1.69

Cited by 199 publications

(13 citation statements)

References 14 publications

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“…[48] Peri-operative pulmonary capillary wedge pressure monitoring has been recommended in view of increased risk of pulmonary hypertension and myocardial depression. [51011]…”

Section: Discussionmentioning

confidence: 99%

Utility of intra-operative ultrasound in choosing the appropriate site for blood pressure monitoring in Takayasu′s arteritis

2013

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Takayasu's arteritis (TA) is rare, chronic progressive, pan-endarteritis involving the aorta and its main branches, with a specific predilection for young Asian women. Anaesthesia for TA patients is complicated by their severe uncontrolled hypertension, extreme arterial blood pressure differentials, aortic regurgitation (AR), end-organ dysfunction, stenosis/aneurysms of major blood vessels and difficulties encountered in monitoring arterial blood pressure. We present the usefulness of ultrasound during anaesthetic management of a 35-year-old woman posted for emergency caesarean section due to intra-uterine growth retardation, foetal tachycardia in active labour, who was already diagnosed to have TA along with moderate AR and uncontrolled hypertension, using epidural technique. The use of intra-operative doppler helped resolve the initial dilemma about the diagnosis and treatment of the differential blood pressure between the affected and the normal upper limb in the absence of prior arteriogram.

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“…[48] Peri-operative pulmonary capillary wedge pressure monitoring has been recommended in view of increased risk of pulmonary hypertension and myocardial depression. [51011]…”

Section: Discussionmentioning

confidence: 99%

Utility of intra-operative ultrasound in choosing the appropriate site for blood pressure monitoring in Takayasu′s arteritis

2013

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“…Several cases have been reported thereafter, and the term 'Takayasu's arteritis' was coined in 1939 2). A year later, pulmonary artery involvement of TA was first described in TA patients and it was reported that pathologic changes of affected pulmonary arteries were very similar to those observed in systemic vessels 4). Subsequently, prevalence of pulmonary artery involvement was estimated approximately 10% to 50% in TA patients, with a variety of pathological manifestations like stenosis, occlusion, or only vessel wall irregularity 5).…”

Section: Discussionmentioning

confidence: 99%

Total Occlusion of Right Main Pulmonary Artery in a Patient with Takayasu's Arteritis and Severe Pulmonary Hypertension

Choi

Kim

Shin

et al. 2012

J Cardiovasc Ultrasound

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“…The clinical course of TA includes a prodromal "prepulseless phase," which is manifested by a variety of constitutional symptoms including pyrexia, weight loss, anorexia, night sweats, malaise, arthralgias, and myalgias. Since these symptoms are nonspecific and protean, they are rarely discernible as a discrete prodromal phase (16, 17). A "pulseless phase" follows months to years later and is attended by peripheral pulse deficits and symptomatic occlusive or aneurysmal arterial disease.…”

Section: Discussionmentioning

confidence: 99%

“…A "pulseless phase" follows months to years later and is attended by peripheral pulse deficits and symptomatic occlusive or aneurysmal arterial disease. The arterial involvement may be confined to the aortic arch as in Takayasu's original patient, or involve multiple aortic segments, or the entire aorta, its major branches, and the pulmonary artery as well (18). Arterial pathology varies from a fulminant acute inflammatory process to extensive post-inflammatory mural fibrosis (19).…”

Section: Discussionmentioning

confidence: 99%

Surgical Management of Takayasu's Arteritis

et al. 2006

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The results of surgical bypass and endarterectomy in Takayasu's arteritis (TA) were reported to be poor compared to usual atherosclerosis patients. However, if ischemic symptoms due to occlusive disease were severe, surgical procedures were inevitable. We report surgical experience of 5 patients with TA. Five women (ranged from 26 to 58 yr) were operated between June 1998 and May 2004. Three patients showed occlusion of main branches of aortic arch and had symptoms of cerebral ischemia. One patient showed near total occlusion in the midabdominal aorta and had symptoms of orthopnea and uncontrolled hypertension. One patient showed total occlusion of abdominal aorta at the level of aortic bifurcation and had a symptom of severe claudication on both legs. Bypasses from the ascending aorta to the carotid artery were performed in 3 cases. Bypass from the thoracic aorta to the left common iliac artery was performed in one case and endarterectomy of abdominal aorta in one case. The ischemic symptoms related with arterial occlusion were resolved after surgery. And the symptoms of cardiac failure disappeared. The symptomatic TA frequently required arterial reconstruction. The symptomatic improvement and excellent mid-term patency could be expected after arterial reconstruction and endarterectomy.

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Pulmonary Artery Involvement in Takayasu's Arteritis

Cited by 199 publications

References 14 publications

Utility of intra-operative ultrasound in choosing the appropriate site for blood pressure monitoring in Takayasu′s arteritis

Utility of intra-operative ultrasound in choosing the appropriate site for blood pressure monitoring in Takayasu′s arteritis

Total Occlusion of Right Main Pulmonary Artery in a Patient with Takayasu's Arteritis and Severe Pulmonary Hypertension

Surgical Management of Takayasu's Arteritis

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