Aneurysm of the Right Sinus of Valsalva After Aortic Valve Replacement in Takayasu Arteritis

Abstract

We herein report a case with an aneurysm of the right sinus of Valsalva, which developed 14 years after an aortic valve replacement (AVR) for aortic regurgitation caused by Takayasu arteritis. The aortic wall around the right coronary artery ostium showed calcification, as a result, the modified Bentall procedure and coronary artery bypass to the right coronary artery were successfully performed. A pathological study of the resected aortic sinus wall showed a disruption of the elastic fibers in the media, granuloma formation, and a marked proliferation of the collagen fibers in the adventitia, and these findings were compatible with Takayasu arteritis. The development of an aneurysm of the sinus of Valsalva late after AVR indicates the necessity of a close and lifelong follow-up for patients with Takayasu arteritis, especially focusing on the aortic root morphology.

Aortic regurgitation and aortic valve operation in Takayasu arteritis: A meta-analysis

“…[50] The timing of complication development was at 66.0±70.1 months (range 0.5-204 months; median 36 months) (n=16) postoperatively. Reintervention for complications was warranted in 13 patients (41.9%), [10,[21][22][23]35,36,38,42,44,47] but Yuan.…”

“…In the surgical group, postoperative cardiac complications occurred in 31 patients (20.7%), [20][21][22][23]32,35,36,38,42,44,47,49,50] and complications occurred twice in one patient at postoperative 18 months and 14 years, respectively. [50] The timing of complication development was at 66.0±70.1 months (range 0.5-204 months; median 36 months) (n=16) postoperatively.…”

“…[12,14,15,20,23,24,28,[30][31][32]47] The degree of AR was not reported in 118 patients (74.2%). [10,16,18,22,26,35,38,45,50] In the remaining 41 patients (25.8%), one (2.4%) was mild, [29] nine (22.0%) were moderate, [11,12,23,34,37,41,42,49] one (2.4%) was moderate-to-severe [37] and 30 (73.2%) were severe [13][14][15]17,[19][20][21]24,25,27,28,[30][31][32][33]36,39,40,[42][43][44]…”

“…[10][11][12]14,15,[17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][38][39][40]42,[44][45][46][47][48][49][50] The aortic valve operations that were performed in these patients were: aortic valve repair in three (2%) [12,30,32] (in one of them, aortic valve repair was performed after a three-week steroid treatment), [32] aortic valve replacement in 98 (65.3%), [10,11,14,17,18,20,[22][23][24][25]...…”

Disorders of the Aorta and Aortic Valve in Connective Tissue Diseases

“…There is a chronic inflammation of the arterial wall, which is transmural and characterized histologically by mononuclear cell infiltrates and fibrosis of the vessel wall that results in stenosis of the lumen in some cases and aneurysm of vessel wall in a few cases [23]. Aortic regurgitation is the valvular disorder that occurs in Takayasu arteritis [37,38] and is the result of aortic root dilation. Echocardiogram shows normal valvular cusps [37].…”