Takayasu's arteritis (TA) is a rare chronic granulomatous inflammatory disease of the aorta, commonly affecting young females. Cardiovascular manifestations of TA include a carotid bruit, blood pressure (BP) differences in arms and claudication of extremities. Anesthesia in TA necessitates precise monitoring of BP. Preservation of end-organ perfusion, especially in cardiac surgery on cardiopulmonary bypass (CPB), is one of the most challenging aspects of anesthesia in TA undergoing aortic surgery. We report a case of a young lady of TA who presented with ascending aortic aneurysm, occlusion of branches of the aorta with severe aortic regurgitation (AR), who underwent Bentall surgery successfully. We also describe the anesthesia implications in this case to demonstrate the challenges of monitoring pulseless disease, maintenance of hemodynamics, and perfusion, which is essential for preventing permanent tissue damage in a tissue-flow compromised state.
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