Transesophageal Echocardiographic Findings in 3 Cases of Takayasu's Arteritis

ABSTRACT

BACKGROUND: Takayasu's arteritis is a chronic non-specific inflammatory disease of arteries and it is known that aorta and its major branches are most commonly invoved. Its etiology is still unknown but the basic process is marked intimal proliferation, fibrosis and fibrous scarring with degeneration of the elastic fibers of the media. The proliferative and cicatrical process leads to luminal narrowing, stenosis, localized aneurysm, postsenotic dilatation and calcification in the involved arterial wall. Little attention has been paid to the diagnostic value of transesophageal echocardiography(TEE) in Takayasu's arteritis. METHODS: We evaluated transesophageal echocardiographic findings of aortic lesions in 3 cases of Takayasu's arteritis. RESULTS: The transesophageal echocardiographic findings of aortic lesions in Takayasu's arteritis characteristically showed relatively long sehmental luminal narrowing caused by marked intimal proliferation and contracture fo aortic wasll. The morphology of intimal thickening was characteristically circumferential, concentric and the size of the aorta itself was decreased by contracture as compared with atherosclerotic changes involving aorta. Besides these findings were consistent with angiographic findings. The common types of Takayasu's arteritis which we will meet clinically are known as type I or III. Indeed, 3 cases described in this paper are all type 3 patients. According to that fact, most of Takayasu's arterits may have aortic lesions that could be easily accessible by TEE and the degree of deformity of the aorta can be evaluated using TEE. CONCLUSION: The transesophageal echocardiography may be a valuable diagnostic tool for the evaluation of aortic wall and luminal status in the patients with Takayasu's arteritis.