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J Thorac Cardiovasc Surg 2005;130:573-574
© 2005 The American Association for Thoracic Surgery

Brief Communication

Surgical approach to aortic root lesions in patients with homozygous familial hypercholesterolemia and Takayasu arteritis

Stéphane Aubert, MD * , Nicolas Bonnet, MD, Pascal Leprince, MD, Théodoro Barreda, MD, Alain Pavie, MD, Iradj Gandjbakhch, MD

Department of Cardiovascular Surgery, Pitié Salpêtrière Hospital, Paris, France

Presented at the French Society of Thoracic and Cardio-vascular Surgery’s Journées d’automne, December 3, 2004.

Received for publication December 31, 2004; revisions received January 21, 2005; accepted for publication February 8, 2005.

* Address for reprints: Stéphane Aubert, MD, Department of Cardiovascular Surgery, Pitié Salpêtrière Hospital, 47-83 boulevard de l’hôpital, 75651 Paris Cedex 13, France (Email: stephaneaubert@yahoo.fr).

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

Patients with homozygous familial hypercholesterolemia (HFH) and Takayasu arteritis are commonly affected by a severe aortic root calcification associated with coronary ostial stenosis. In these patients a long-term outcome of the coronary artery bypass graft is a permanent preoccupation because of the high risk of progressive arteriosclerosis after surgical repair. We propose an enlargement plasty of the proximal segment of the coronary arteries with a saphenous patch, followed by an aortic root replacement with a composite tube graft and coronary reimplantation.

Clinical Summary

Two patients with HFH and 1 with Takayasu arteritis had severe aortic root calcifications associated with coronary ostial stenosis (1 male and 2 female patients; mean age, 30 ± 14 years). Mean aortic gradient ranged from 30 to 70 mm Hg, with a valvular stenosis in 1 and a supravalvular aortic stenosis in all. All 3 patients had severe ostial coronary stenosis observed by systematic catheterization (occlusion in the case of one right coronary artery). Only 1 patient had angina on . . . [Full Text of this Article]




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