Repair of Aortic Regurgitation due to Takayasu Arteritis

Authors

  • ChengNan Li
  • YongMin Liu
  • RuiDong Qi
  • Jun Zheng
  • JunMing Zhu
  • Qian Chang
  • LiZhong Sun

DOI:

https://doi.org/10.1532/HSF98.20121059

Abstract

Background: Prosthetic valve detachment after aortic valve replacement and pseudoaneurysm formation are the most important postoperative complications in patients with Takayasu arteritis with aortic regurgitation. We reviewed our experience of surgical treatment of aortic regurgitation in patients with Takayasu disease.

Methods: Between November 1997 and September 2011, 11 patients (4 women and 7 men) with Takayasu arteritis with aortic regurgitation underwent surgical treatment. The age of the patients ranged from 26 to 56 years (mean, 40 ± 9 years). Primary isolated aortic valve replacement was performed in 1 patient, David procedure in 1 patient, Wheat procedure in 1 patient, Bentall procedure in 2 patients, and Cabrol procedure in 6 patients (including 2 patients who underwent primary aortic valve replacement in other hospitals before being admitted to our surgical team).

Results: There was no in-hospital death. All patients had an uneventful recovery during the postoperative course and were discharged. Prosthetic valve detachment, pseudoaneurysm formation at the suture line, and dilatation of the ascending aorta were not found in patients with composite aortic root replacement during a mean follow-up of 98 ± 45 months. One patient died during follow-up.

Conclusion: Valve detachment after composite aortic root replacement was not observed in patients with Takayasu disease with aortic regurgitation. Satisfactory surgical outcomes were obtained using composite aortic root replacement. However, close follow-up was needed to assess the effectiveness of the Cabrol procedure in patients with Takayasu disease with aortic regurgitation.

References

Adachi O, Saiki Y, Akasaka J, Oda K, Iguchi A, Tabayashi K. 2007. Surgical management of aortic regurgitation associated with takayasu arteritis and other forms of aortitis. Ann Thorac Surg 84:1950-3.nAndo M, Kosakai Y, Okita Y, Nakano K, Kitamura S. 1998. Surgical treatment for aortic regurgitation caused by Takayasu's arteritis. J Card Surg 13:202-7.nAoyagi S, Akashi H, Kawara T, et al. 1998. Aortic root replacement for Takayasu arteritis associated with ulcerative colitis and ankylosing spondylitis—report of a case. Jpn Circ J 62:64-8.nKalangos A, Baldovinos A, Beghetti M, Vala D, Faidutti B. 1999. Ascending aortic aneurysm associated with aortic insufficiency due to Takayasu's arteritis. Ann Thorac Surg 68:248-50.nKouchoukos NT, Marshall WG Jr, Wedige-Stecher TA. 1986. Eleven-year experience with composite graft replacement of the ascending aorta and aortic valve. J Thorac Cardiovasc Surg 92:691-705.nKourliouros A, Soni M, Rasoli S, et al. 2011. Evolution and current applications of the Cabrol procedure and its modifications. Ann Thorac Surg 91:1636-41.nMatsuura K, Ogino H, Kobayashi J, et al. 2005. Surgical treatment of aortic regurgitation due to Takayasu arteritis: long-term morbidity and mortality. Circulation 112: 3707-12.nMiyata T, Sato O, Deguchi J, et al. 1998. Anastomotic aneurysms after surgical treatment of Takayasu's arteritis: a 40-year experience. J Vasc Surg 27:438-45.nMiyata T, Sato O, Koyama H, Shigematsu H, Tada Y. 2003. Long-term survival after surgical treatment of patients with Takayasu's arteritis. Circulation 108:1474-80.nOgino H, Matsuda H, Minatoya K, et al. 2008. Overview of late outcome of medical and surgical treatment for Takayasu arteritis. Circulation 118:2738-47.nOkita Y. 2007. Invited commentary. Regurgitation develops primarily as a result of annular dilatation resulting from enlargement of the ascending aorta. Ann Thorac Surg 84:1953-4.nSuzuki A, Amano J, Tanaka H, Sakamoto T, Sunamori M. 1989. Surgical consideration of aortitis involving the aortic root. Circulation 80:I222-32.nTsunekawa T, Ogino H, Matsuda H, et al. 2008. Composite valve graft replacement of the aortic root: twenty-seven years of experience at one Japanese center. Ann Thorac Surg 86:1510-7.n

Published

2013-02-25

How to Cite

Li, C., Liu, Y., Qi, R., Zheng, J., Zhu, J., Chang, Q., & Sun, L. (2013). Repair of Aortic Regurgitation due to Takayasu Arteritis. The Heart Surgery Forum, 16(1), E24-E26. https://doi.org/10.1532/HSF98.20121059

Issue

Section

Articles