Descending Thoraco - Thoracal Aortic Graft Bypass for atypical

coartation due to Takayasu's Arteritis: A Case Report

Usman, Umar; Hakim, Arif Rahman; Puruhito*
* Thoracic Cardiac and Vascular Surgery Division, Dr. Soetomo Teaching Hospital, Airlangga University Surabaya

Background : Takayasu's arteritis is a non-specific inflammatory disease of unknown

etiology that principally affects the aorta and its main branches. Atypical coarctation due to
Takayasu's arteritis often requires aorto-aortic bypass because the diseased portions of the
vessels of occlusive lesion usually have severe stenosis. In Indonesia, the Descending
Thoraco - Thoracal Aortic Graft Bypass for Takayasu's arteritis is rarely selected because it is
so invasive, requiring a thoracotomy. We report a successful descending Thoraco - Thoracal
Aortic Graft Bypass in a 14-year-old woman with atypical coarctation.
Objectives : To report the management of atypical coartation due to Takayasu's Arteritis by
Descending Thoraco - Thoracal Aortic Graft at the Soetomo General Hospital, Surabaya.
Case Description : A 14-year-old woman with atypical coarctation due to Takayasu's
arteritis was successfully and safely treated with Descending Thoraco - Thoracal Aortic Graft
Bypass, The patient was admitted to our hospital complaining of of left extremities weakness
since 1 month prior to admission and leg fatigue. Hypertension and differences between
upper- and lower-limb blood pressure values were observed, and pulse on lower extremities
was unpalpable. Angiography showed a narrowed segment of the descending aorta at 4th
thoracal vertebrae level, aortic balloning had performed, but didn’t give a good result.
Because hypertension control was poor and lower extremitiy claudication, a descending
Thoraco - Thoracal Aortic Graft Bypass with an artificial graft was undertaken via
thoracotomy approach.
Result : The hypertension and other symptoms improved remarkably, and she was
discharged on the 14th postoperative day
Conclusion : Although the long-term prognosis for the patient is unknown, this surgical
technique can be considered effective and safe for atypical coarctation.
Key Words : Atypical coarctation; Takayasu's arteritis; Descending Thoraco - Thoracal
Aortic Graft Bypass