Takayasu's Disease Associated with Ulcerative Colitis.

Sato, Ryo; Satô, Yukio; Ishikawa, Hidemasa; Oshima, Yasuyoshi; Suzuki, Tomohiro; Watanabe, Shigeru; Oyanagi, Hironobu; Sekine, Kenji; Kondo, Yuichiro; Miyata, Masayuki; Obara, Katsutoshi; Nishimaki, Tomoe; Kasukawa, Reiji

doi:10.2169/internalmedicine.33.759

Cited by 31 publications

(16 citation statements)

References 18 publications

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“…Several vascular complications have been described associated with UC including different forms of aortitis [16], vasculitis [17], capillaritis [18] and panniculitis with vasculitis [19]. There are several reports showing a combination of Takayasu's arteritis and UC [20,21]. Activation of coagulation system could develop in some patients with aortic [22][23][24][25], retinal artery [26], splanchnic artery, portal vein [27] and pulmonary artery [28] embolism, and disseminated intravascular coagulopathy (DIC) [29].…”

Section: Discussionmentioning

confidence: 99%

Increased aortic stiffness in ulcerative colitis

et al. 2014

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Section: Discussionmentioning

confidence: 99%

Increased aortic stiffness in ulcerative colitis

et al. 2014

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“…The relatively rare combination of aortitis syndrome and ulcerative colitis suggests that they may have a common pathological background and an autoimmune genetic influence in Japanese patients, but the details are still unknown. 1,2 In patients with aortic regurgitation and/or dilatation of the aortic root, AVR and/or root reconstruction are indicated. Cardiovascular symptoms may occur while the gastrointestinal disease is quiescent.…”

Section: Discussionmentioning

confidence: 99%

Reoperation for Ascending Aortic Aneurysm, Coronary Ostial Aneurysm and Patent Cabrol Trick After Bentall Operation for Aortitis Syndrome

Shiono

Hata

Sezai

et al. 2005

Circ J

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ortitis is chronic inflammation of the aorta, its branches and the pulmonary artery that leads to stenosis/occlusion or dilatation. Cardiovascular complications, such as aortic regurgitation and aneurysmal dilatation of the aortic root, can be fatal. The most serious complication after aortic valve replacement (AVR) or root reconstruction for aortitis syndrome is dehiscence of the anastomotic site. We report a patient with aortitis syndrome associated with ulcerative colitis who underwent the Bentall operation for annuloaortic ectasia and aortic regurgitation, but required reoperation for anastomotic dehiscence 9 years later. Case ReportA 38-year-old woman with aortitis syndrome associated with ulcerative colitis underwent an original Bentall operation for annuloaortic ectasia with severe aortic insufficiency in December 1995. At the time of initial operation a composite Dacron graft with a 27-mm mechanical valve was used, and both coronary ostia were directly anastomosed to the composite valved graft, which was wrapped with the native aortic wall, together with interposition using a tube graft between the aorta and right atrium (Cabrol trick). Pathology revealed low-grade inflammation of the aortic wall with interrupted elastic fibers, which was compatible with a diagnosis of aortitis (Fig 1). The patient was well until 5Circulation Journal Vol.69, July 2005 years later when she had shortness of breath and anemia (Fig 2). Preoperative chest computed tomography and angiography revealed a patent Cabrol trick, aneurysmal dilatation of the ascending aorta and aortic arch around the artificial graft, coronary ostial aneurysms, and paravalvular leakage (Fig 3). She had a history of steroid therapy for the ulcerative colitis.At the time of reoperation, dense adhesions were found especially around the Cabrol trick and the ascending aorta was dilated more than 60 mm. The femoral artery was cannulated for arterial perfusion. Two-staged venous cannulation was carried out through a small right atriotomy. After implementation of cardiopulmonary bypass, the ascending aorta was cross-clamped obliquely beyond the distal anastomotic site of the previous graft. After clamping the Cabrol trick, aortotomy of the dilated ascending aorta and Dacron graft revealed that the internal aortic wall was normal color and that the native aortic wall around both coronary ostia was dilated. Cold crystalloid cardioplegic solution was antegradely administered through both coronary ostia. Anastomotic dehiscence was found at the distal anastomosis of the Dacron graft and at the non-coronary cusp site of the proximal composite graft, but not at either of the coronary ostia (Fig 4). The primary dehiscence was considered to be the distal site of the graft, resulting in aneurysmal dilatation of the wrapped aorta. Paravalvular leakage was considered to have begun 5 years after the initial operation when the inflammation deteriorated (Fig 2).The Dacron graft was totally removed, leaving intact the sewing ring of the mechanical valve. A new 30-mm Dacron ...

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“…This entity is rare in Western countries and even more rare in patients with IBD. Aortitis associated with IBD has been reported mostly from Japan, and mainly in ulcerative colitis patients (7)(8)(9). In a recent review, only 20 reports of patients with the association of Crohn's disease and Takayasu's disease were found in the literature (10).…”

Section: Discussionmentioning

confidence: 99%