This Article Full Text Full Text (PDF) All Versions of this Article: 112/24/3707    most recent CIRCULATIONAHA.105.535724v1 Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Matsuura, K. Articles by Kitamura, S. Search for Related Content PubMed PubMed Citation Articles by Matsuura, K. Articles by Kitamura, S. Pubmed/NCBI databases Substance via MeSH Related Collections CV surgery: aortic and vascular disease

(Circulation. 2005;112:3707-3712.)
© 2005 American Heart Association, Inc.

Cardiovascular Surgery

Surgical Treatment of Aortic Regurgitation due to Takayasu Arteritis

Long-Term Morbidity and Mortality

Kaoru Matsuura, MD; Hitoshi Ogino, MD; Junjiro Kobayashi, MD; Hatsue Ishibashi-Ueda, MD; Hitoshi Matsuda, MD; Kenji Minatoya, MD; Hiroaki Sasaki, MD; Ko Bando, MD; Kazuo Niwaya, MD; Osamu Tagusari, MD; Hiroyuki Nakajima, MD; Toshikatsu Yagihara, MD; Soichiro Kitamura, MD

From the Departments of Cardiovascular Surgery (K. Matsuura, H.O., J.K., H.M., K. Minatoya, H.S., K.B., K.N., O.T., H.N., T.Y., S.K.) and Pathology (H.I.-U.), National Cardiovascular Center, Osaka, Japan.

Reprint requests to Hitoshi Ogino, MD, Department of Cardiovascular Surgery, National Cardiovascular Center, 5-7-1 Fujishirodai, Suita, Osaka, Japan 565-8565. E-mail hogino{at}hsp.ncvc.go.jp

Received January 12, 2005; revision received September 12, 2005; accepted September 14, 2005.

Background— The goal of this retrospective study was to determine the late outcome of surgical treatment for aortic valve regurgitation due to Takayasu arteritis and correlate it with evidence of inflammation on pathological examination.

Methods and Results— Ninety consecutive patients who underwent surgery for aortic valve regurgitation due to Takayasu arteritis between 1979 and 2003 were studied. Intraoperative pathological specimens of the aortic wall from 69 patients were retrospectively examined for inflammation. Aortic valve replacement was performed in 63 patients (group A) and composite graft repair in 27 patients (group B). The aortic root diameter was 39.9±9.5 mm in group A and 54.4±13.6 mm in group B (P<0.0001). Preoperative steroid therapy was performed in 40 patients (44.4%). Hospital mortality was 4.8% (3/63) in group A and 7.4% (2/27) in group B. The overall 15-year survival rate was 76.1%. Detachment of the valve or graft occurred in 11.1% (7/63) of group A and in 3.7% (1/27) of group B patients (P=0.43). Late dilatation (>50 mm) of the residual ascending aorta occurred in 11.1% (7/63) of group A and in 3.7% (1/27) of group B patients (P=0.43). Active inflammation was confirmed in intraoperative pathological specimens of 10 patients, and detachment of the valve or graft occurred in 4 of these patients. Univariate analysis of background variables revealed active inflammation to be a risk factor for detachment (P=0.0001; risk ratio 55).

Conclusions— Late dilatation of the ascending aorta after aortic valve replacement is a clinically important finding. Active inflammation could be related to valve or graft detachment.

Key Words: aorta • complications • inflammation • surgery • valves

This article has been cited by other articles:

				O. Adachi, Y. Saiki, J. Akasaka, K. Oda, A. Iguchi, and K. Tabayashi Surgical Management of Aortic Regurgitation Associated With Takayasu Arteritis and Other Forms of Aortitis Ann. Thorac. Surg., December 1, 2007; 84(6): 1950 - 1953. [Abstract] [Full Text] [PDF]