Clinical Course After Transcatheter Aortic Valve Replacement for Takayasu Arteritis–Related Aortic Stenosis and Regurgitation

Figures

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  Visual Summary. Clinical Course After TAVR for TAK-Related ASr ASr = aortic valve stenosis and regurgitation; TAK = Takayasu arteritis; TAVR = transcatheter aortic valve replacement.

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  Figure 1. Imaging of Patient 1 Computed tomography revealed circumferential aortic calcification between the aortic root and the descending aorta, left common carotid artery occlusion, and circumferential calcification of both subclavian arteries and the internal thoracic artery.

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  Figure 2. Postoperative Course of Patient 1 Trends in C-reactive protein (CRP) level, erythrocyte sedimentation rate (ESR), white blood cell (WBC) count, and prednisolone (PSL) dosage after transcatheter aortic valve replacement. The patient experienced a relapse of Takayasu arteritis (TAK) at approximately day 1,500, with the subsequent reintroduction of PSL. Moderate aortic regurgitation (AR) developed, and the patient died 7 years 3 months postoperatively.

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  Figure 3. Imaging of Patient 2 (A) Computed tomography revealed circumferential aortic calcification extending from the aortic root to the descending and abdominal aorta, as well as 50% stenosis of the left common carotid artery. (B) Coronary computed tomography angiography revealed patency of the saphenous vein graph (SVG) in the obtuse marginal branch, whereas the SVG in the left anterior descending artery was occluded (yellow arrow).

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  Figure 4. Postoperative Course of Patient 2 Trends in C-reactive protein (CRP) level, erythrocyte sedimentation rate (ESR), white blood cell (WBC) count, and prednisolone (PSL) dosage after transcatheter aortic valve replacement. Inflammatory markers remained stable under low-dose PSL, with no evidence of Takayasu arteritis relapse throughout the follow-up period.

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  Figure 5. Imaging of Patient 3 Computed tomography revealed widespread calcified stenoses affecting (A and B) the bilateral common and internal carotid arteries, (C) left subclavian artery (red arrow), and (D) superior mesenteric artery. (E) Coronary computed tomography angiography revealed the patency of the left internal thoracic artery graft in the left anterior descending and posterolateral branches.

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  Figure 6. Postoperative Course of Patient 3 Trends in C-reactive protein (CRP) level, erythrocyte sedimentation rate (ESR), and white blood cell (WBC) count after transcatheter aortic valve replacement. CRP levels remained low during follow-up, whereas the ESR fluctuated mildly.