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J Thorac Cardiovasc Surg 2003;125:721-723
© 2003 The American Association for Thoracic Surgery

Brief Communications

Coronary-coronary bypass and pulmonary artery reconstruction related to Wegener granulomatosis in a 22-year-old woman

Arata Murakami, MDa, Noboru Motomura, MDa, Tetsuhiro Takaoka, MDa, Jyotaro Kobayashi, MDa, Katsuhide Maeda, MDa, Tetsushi Yamamoto, MDa, Masahide Chikada, MDb, Toshiya Ootsuka, MDa, Yutaka Kotsuka, MDa, Shinichi Takamoto, MDa Tokyo, Japan

From the Department of Cardiothoracic Surgery, Faculty of Medicine, University of Tokyo,a and the Department of Cardiovascular Surgery, National Children's Hospital,b Tokyo, Japan.

Received for publication May 21, 2002. Accepted for publication July 3, 2002. Address for reprints: Arata Murakami, MD, Department of Cardiothoracic Surgery, Faculty of Medicine, University of Tokyo, 7-3-1, Hongou, Bunkyou-ku, Tokyo, 113-8655, Japan (E-mail: MURAKAMI-THO@h.u-tokyo.ac.jp).

The first 20% of the full text of this article appears below.

We report a case of left coronary artery ostial stenosis and bilateral pulmonary artery (PA) stenosis in a 22-year-old woman with Wegener granulomatosis (WG). Complicating periaortitis and obstruction of the internal thoracic arteries hampered conventional coronary artery bypass grafting and in situ PA reconstruction. Successful treatment was achieved by restoration of right ventricular outflow tract (RVOT) to bilateral PA continuities with reinforced polytetrafluoroethylene (PTFE) grafts and coronary-coronary bypass.

Clinical summary

A 22-year-old woman was seen with chest pain. The diagnosis of WG was based on the eye, ear, and nose findings. Prednisolone had been started when the patient was 3 years old and continued for 4 years. A left ocular tumor was removed when she was 6 years old. A heart murmur was detected, and balloon pulmonary angioplasty was performed when she was 7 years old. Chest pain developed at 19 years of age. A 75% left coronary artery ostial stenosis (Figure 1, A) and bilateral branch PA stenoses were diagnosed when the patient was 21 years old and an operation was performed at another hospital. This operation consisted of two aorta-coronary bypass procedures with saphenous venous grafts and RVOT . . . [Full Text of this Article]






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