The Surgical Treatment of Aortic Regurgitation Secondary to Aortitis

Follow-up Study of Aortic-Valve Replacement Surgery in Patients With Takayasu's Disease Complicated by Aortic Regurgitation.

“…[1][2][3] Aortic-valve replacement surgery is considered as the only curative treatment, but frequent remote cardiovascular complications, including detachment of the prosthetic valve, infective endocarditis, pseudoaneurysmal formation and cerebrovascular disease, make clinicians hesitant to perform this therapy. [4][5][6] In the 6 patients treated by aortic-valve replacement surgery, there was a reduction in the size of the left ventricle and improvement in the ejection fraction at follow-up, similar to previous reports of aortic valve replacement surgery in patients with AR of other etiologies. 7,8 None of the present cases had evidence of postoperative cerebral ischemia and preoperative hypertension resolved soon after surgery.…”

Aortic Valve Replacement for Aortic Regurgitation Caused by Aortitis

“…Although the administration of steroids in the early postoperative period has some potential hazards, such as susceptibility to infection and disturbance of the woundhealing process, we believe that it should be started in the early postoperative period in patients who are operated on during the active phase of aortitis, and should be maintained until normalization of CRP and the ESR. Some investigators, 3,9,15 including ourselves, 16 recommend the use of pledgeted interrupted sutures or transmural buttressed sutures to prevent valve detachment after AVR. In one of the present patients the aortic prosthetic valve was implanted with transmural pledgeted sutures in the second operation; however, pseudoaneurysm formation resulting from disruption of the aortic wall led to a recurrence of valve detachment.…”

Surgical Treatment of Aortic Regurgitation due to Takayasu Arteritis

“…1 Although its most common lesions are in the proximal segments of arteries arising from the transverse aortic arch, the incidence of aortic valve regurgitation (AR) in patients with Takayasu arteritis is between 13% and 25%, and AR is now considered an important risk factor for mortality in patients with this disease. [2][3][4][5][6][7][8][9][10][11] Furthermore, the most serious complication of aortic valve replacement (AVR) or aortic root replacement is detachment of the prosthetic valve or graft. 12 When patients with AR and aortic root dilatation are encountered, they must be treated carefully both surgically and medically.…”