Surgery for aortic regurgitation and aortic root dilatation in Takayasu arteritis

Kaku, Yuji; Aomi, Shigeyuki; Tomioka, Haruaki; Yamazaki, Kenji

doi:10.1177/0218492315591291

Cited by 28 publications

(33 citation statements)

References 17 publications

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“…One article (2.4%) was an original article, [10] two (4.9%) were case series, [26,42] The presenting symptoms were available for 32 patients with 63 manifestations. The major manifestations were circulatory (41.3%), followed by constitutional (25.4%), pains (17.5%), neurological (9.5%) and local symptoms (4.8%).…”

Section: Resultsmentioning

confidence: 99%

“…[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]…”

Section: Resultsmentioning

confidence: 99%

“…[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][46][47][48] (c 2 =17.9, p<0.001). Seven patients (4.4%) were associated with mitral regurgitation [23,26,42,47] and one patient (0.6%) was associated with pulmonary valve regurgitation. [14] By preoperative imaging, the left ventricular dimension was detected in 23 patients (14.5%).…”

Section: Resultsmentioning

confidence: 99%

“…[48] In 33 patients (20.8%), the type of TA could be tracked: five (15.2%) were type 1, [28,33,34,37,47] 21 (63.6%) were type 2a, [11][12][13][14][17][18][19][20][21][22][23][24]27,29,30,36,38,39,46,48,49] one (3.0%) was type 2b, [31] three (9.1%) were type 3, [32,40,41] two (6.1%) were type 4, and one (3.0%) was type 5. [16] The activity of TA could be traced in 42 patients (26.4%): 37 (88.1%) were active [12,[14][15][16][18][19][20][21][22][23][24]26,28,[30][31][32]36,37,…”

Section: Resultsmentioning

confidence: 99%

“…[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]...…”

Section: Resultsmentioning

confidence: 99%

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

Yuan¹

2017

Turk Gogus Kalp Dama

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ÖZAmaç: Bu çalışmada Takayasu arteriti olan hastaların majör bir komplikasyonu olabilen aort regürjitasyonunun klinik özellikleri ile beraber bu hastalarda gereken aort kapak ameliyatları tanımlandı.Ça lış ma pla nı: Bu meta-analiz; literatürden erişilen, Ocak 2001 ve Aralık 2016 tarihleri arasında yayınlanan ve 159 Takayasu arteriti hastasını içeren 41 ilgili yazıya dayandırıldı. On iki erkek ve 55 kadın hasta varken 92 hastanın cinsiyet bilgisi yoktu. Bul gu lar:Takayasu arteriti popülasyonunun aort regürjitasyonu hastası profili; kadın cinsiyetinin, tip 2a Takayasu arteritinin ve aort regürjitasyonunun şiddetli derecesinin hakim olduğunu gösterdi. Çoğu, en yaygını aort kapak replasmanı veya kompozit greft replasmanı olmak üzere aort kapak ameliyatı gerektirdi. Eşzamanlı kalp ameliyatları içinde en sık olan koroner arter baypas greftleme idi; Takayasu arteriti kaynaklı arteriyel greft patensi endişesi nedeniyle safen ven tercih edilen bir greft seçeneği idi. Ameliyat sonrası kardiyak komplikasyonlar 31 hastada (%20.7) oluştu ve 13'ünde (%41.9) yeniden girişim gerekti. Lojistik regresyon analizi ameliyat sonrası komplikasyonlar için belirleyici risk faktörlerinin primer aort kapak ameliyatı ve eşzamanlı kalp ameliyatı olduğunu ortaya koydu. Tüm hasta popülasyonun mortalite oranı %21.5 idi.So nuç: Takayasu arteriti aort regürjitasyonuna neden olabilir ve hastaların çoğunluğunda aort kapak ameliyatı gerekir. Ameliyat sonrası komorbidite oranı yüksektir. Ameliyat sonrası komplikasyonları ve sonraki yeniden girişimleri önlemek için aort kapak ameliyatları sırasında güçlendirici tekniklerden yararlanılması, Takayasu arteritinin aktif bir evresinde kardiyak ameliyatlardan kaçınılması ve ameliyat sonrası steroid tedavisi önerilmektedir.Anah tar söz cük ler: Aort regürjitasyonu; aort kapak replasmanı; Takayasu arteriti. ABSTRACTBackground: This study aims to describe the clinical features of aortic regurgitation, which can be a major complication of patients with Takayasu arteritis, as well as necessitated aortic valve operations in such patients.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 3 more Smart Citations

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

Yuan¹

2017

Turk Gogus Kalp Dama

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Transcatheter aortic valve implantation for severe pure aortic regurgitation due to active aortitis

Ruggiero

Ponticelli

Giannini

et al. 2020

Cathet Cardio Intervent

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Aortitis is an uncommon systemic inflammatory disease affecting the aorta and its main branches. Severe aortic regurgitation (AR) represents a fearsome complication of aortitis and is associated with an increased mortality rate. Surgical aortic valve replacement represents the only treatment choice for these patients. However, it is associated with a higher risk of medium to long‐term complications such as prosthetic valve detachment. This is the first reported case where severe AR secondary to aortitis was managed with transcatheter aortic valve implantation (TAVI). TAVI was safe and effective in this clinical setting and may be considered a viable alternative to high‐risk surgery in these complex patients.

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Vascular surgery: the main risk factor for mortality in 146 Takayasu arteritis patients

et al. 2017

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Takayasu arteritis (TA) is an idiopathic chronic inflammatory disease that affects the aorta and its main branches. According to disease involvement, patients may require surgical treatment mainly due ischemic lesions in association with medical therapy. We evaluated the impact of vascular interventions in a cohort of TA patients. Medical records from 146 TA patients were reviewed. Clinical features, medical, and surgical treatment were revised and disease activity was determined by clinical, laboratorial, and imaging parameters. Clinical parameters associated with mortality alongside vascular procedures were evaluated and their impact on mortality in our cohort was estimated. Ninety-four vascular interventions were performed in 61 patients (41.8%). A third of them were of endovascular procedures. The overall mortality was 4.1%, all due to early postoperative complications, which resulted in a rate of surgery-related mortality of 9.8%. All deaths occurred in patients with active disease. Clinical parameters known to be associated with mortality (aneurysm, secondary hypertension, aortic insufficiency, and cerebrovascular accident) were not found related with death. Patients whose disease began before age 20 years had an OR 3.54 of undergoing a vascular surgical intervention. The observed impact of vascular procedures on mortality in patients with Takayasu arteritis, especially during disease activity, supports the notion that such interventions should be performed with caution and preferably during periods of remission.

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Surgery for aortic regurgitation and aortic root dilatation in Takayasu arteritis

Abstract: The early surgical outcome was acceptable but surgical reintervention was required because of late dilatation of the residual aorta or recurrent aortic regurgitation due to annular dilatation, and longstanding careful follow-up will be needed.

Cited by 28 publications

References 17 publications

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

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

Transcatheter aortic valve implantation for severe pure aortic regurgitation due to active aortitis

Vascular surgery: the main risk factor for mortality in 146 Takayasu arteritis patients

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