Surgical management of aortic regurgitation associated with takayasu arteritis and other forms of aortitis.
ABSTRACT Surgical management of aortic regurgitation associated with aortitis can be complicated with occurrence of prosthetic valve detachment or formation of pseudoaneurysm at the suture line. Postoperative morbidity includes progressive dilatation of the aortic root. We sought to assess our midterm and long-term results of surgical management of aortic regurgitation associated with aortitis.
Between January 1989 and September 2004, 15 patients (17 cases) with aortic regurgitation caused by aortitis were surgically treated. Of 17 cases, 6 cases had aortic valve replacement and 11 cases had aortic root replacement. All the patients were followed up from 3 months to 15 years with a mean follow-up period of 70.8 +/- 54.9 months.
There was no hospital death in all the procedures. During the follow-up period, 1 patient died of prosthetic valve detachment, and 2 patients required aortic root replacement for prosthetic valve detachment or aortic root dilatation after aortic valve replacement, whereas there was neither cardiac death nor reoperation after aortic root replacement.
Low operative mortality and favorable long-term outcome may justify lowering the threshold toward aortic root replacement for aortic regurgitation with aortitis in view of the propensity for development of prosthetic valve detachment.
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ABSTRACT: Takayasu's aortitis patients present a variety of symptoms, including angina pectoris, aortic valve regurgitation, and aortic branch stenosis. The case described in this paper primarily presented with angina pectoris. Close investigation revealed a left coronary artery ostium lesion, an aortic root aneurysm, and a mild aortic regurgitation. The patient underwent a modified Bentall operation with saphenous vein graft (SVG) replacement of the left main trunk. The postoperative course was uneventful, and the patient received oral steroid therapy. SVG is a useful option in treating aortic root aneurysm with an ostium lesion.Annals of thoracic and cardiovascular surgery : official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia. 10/2010; 16(5):373-5.