Journal of Acute Care

Register      Login

VOLUME 1 , ISSUE 2 ( May-August, 2022 ) > List of Articles


Implications for Anesthesia in Takayasu's Arteritis for Bentall Surgery

Priya Jain, Varun Shetty

Keywords : Anesthesia implication, Aorta occlusion, Bentall surgery, Takayasu arteritis

Citation Information : Jain P, Shetty V. Implications for Anesthesia in Takayasu's Arteritis for Bentall Surgery. 2022; 1 (2):76-79.

DOI: 10.5005/jp-journals-10089-0021

License: CC BY-NC 4.0

Published Online: 31-12-2022

Copyright Statement:  Copyright © 2022; The Author(s).


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.

  1. Johnston SL, Lock RJ, Gompels MM. Takayasu arteritis. J Clin Pathol 2002;55(7):481–486. DOI: 10.1136/jcp.55.7.481
  2. Onen F, Akkoc N. Epidemiology of Takayasu arteritis. Presse Med 2017;46(7-8 Pt 2):e197–e203. DOI: 10.1016/j.lpm.2017.05.034
  3. Takayasu M. A case with peculiar changes of the central retinal vessels. Acta Societati sophthalmologicae Japonicae, Tokyo 1908;12:554.
  4. Moriwaki R, Noda M, Yajima M, et al. Clinical manifestations of Takayasu arteritis in India and Japan–new classification of angiographic findings. Angiology 1997;48(5):369–379. DOI: 10.1177/000331979704800501
  5. Águeda AF, Monti S, Luqmani RA, et al. Management of Takayasu arteritis: a systematic literature review informing the 2018 update of the EULAR recommendation for the management of large vessel vasculitis. RMD Open 2019;5(2):e001020. DOI: 10.1136/rmdopen-2019-001020
  6. Liu MM, Reidy AB, Saatee S, et al. Perioperative steroid management: approaches based on current evidence. Anesthesiology 2017;127(1):166–172. DOI: 10.1097/ALN.0000000000001659
  7. Baysal A, Rabus MB, Alsalehi S, et al. A young woman with Takayasu arteritis: surgical and anesthetic management of Bentall procedure in a patient with abdominal aortic aneurysm and renal artery stenosis. Kardiochirurgia I Torakochirurgia Polska 2013;10(4):422–424. DOI: 10.5114/kitp.2013.39747
  8. Hirabayashi Y, Fujita A, Seo N, et al. Cervicalspine movement during laryngoscopy using the airway scope compared with the macintosh laryngoscope. Anaesthesia 2007;62(10):1050–1055. DOI: 10.1111/j.1365-2044.2007.05188.x
  9. Yoshida M, Yamamoto T, Shiiba S, et al. Anaesthetic management of a patient with Takayasu arteritis. Anesth Prog 2016;63(1):31–33. DOI: 10.2344/14-00006R1.1
  10. Kathirvel S, Chavan S, Arya VK, et al. Anesthetic Management of Patients with Takayasu's Arteritis: a case series and review. Anesth Analg 2001;93(1):60–65. DOI: 10.1097/00000539-200107000-00014
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.