A Case of Early Progressive Aortic Valve Regurgitation after Coronary Artery Bypass Grafting in Aortitis Patient with Negative Findings for C-Reactive Protein and the Erythrocyte Sedimentation Rate

(Department of Cardiovascular Surgery, Kagoshima Medical Center, Kagoshima, Japan)

Kosuke Mukaihara Goichi Yotsumoto Tomoyuki Matsuba
Kazuhisa Matsumoto Takayuki Ueno Yoshihiro Fukumoto
Hitoshi Toyohira Masafumi Yamashita
We report the case of a 55-year-old woman with aortitis syndrome. She was admitted to our hospital because of repeated chest pain and syncope. An electrocardiogram and the laboratory data suggested acute myocardial infarction, and coronary angiography showed severe bilateral coronary ostial stenosis. No valvular disease was observed. Aortitis syndrome was suspected because of the stenosis of the brachiocephalic artery in addition to the bilateral coronary ostial stenosis, while the patient did not have elevated C-reactive protein(CRP)and erythrocyte sedimentation rate(ESR). Coronary artery bypass grafting was performed, and the patient’s postoperative course was uneventful. However, she again experienced chest pain 9 months after surgery due to aortic regurgitation(AR)and diffuse narrowing change of the left internal thoracic artery graft. Aortic valve replacement and Re-CABG was performed, and the patient was treated with steroid therapy postoperatively. The postoperative course was uneventful, but the patient thereafter died due to bleeding of a malignant adrenal tumor at 21 months after the second surgery.
  Jpn. J. Cardiovasc. Surg. 41:238-242(2012)

Keywords:aortitis, aortic valve replacement, coronary artery bypass grafting, C-reactive protein, erythrocyte sedimentation rate