Surgical outcome of aortic arch repair for patients with Takayasu arteritis.
BACKGROUND
Takayasu arteritis can cause segmental dilatation or stenosis of the aorta and its major branches, and surgical treatment of it is still difficult. Our objective was to review late results of aortic arch repair for patients with Takayasu arteritis.


METHODS
Between 1987 and 2003, 21 patients underwent aortic arch repair under circulatory arrest. Diagnosis was performed by pathologic study of specimens for all patients. Total aortic arch repair was performed in 12 patients with separated branched grafts and in 2 patients with the island technique. Selective cerebral perfusion was used in 12 patients and retrograde cerebral perfusion in 2 patients in this type of surgery. Hemiarch replacement using retrograde cerebral perfusion was performed in 7 patients. Craniocervical vascular stenosis was found in 7 patients and aneurysm in 5 patients. The elephant trunk technique was used in 10 patients. The follow-up period was 6.2 +/- 4.2 years.


RESULTS
There was one hospital death due to renal failure, and two late deaths, both of which were sudden. Late in follow-up, a patient who had undergone hemiarch replacement 12 years previously required total aortic arch repair for dilatation of the distal arch. Three patients required thoracoabdominal aortic repair and one patient descending aortic repair for residual aortic dilatation late in follow-up. Postoperative spinal infarction occurred in one patient who underwent hemiarch replacement.


CONCLUSIONS
Surgical and late outcomes of aortic arch repair under circulatory arrest appear favorable, though late dilatation of the residual aorta is a matter of concern.
Matsuura
Kaoru
K
National Cardiovascular Center, Suita City, Osaka, Japan.
Ogino
Hitoshi
H
Matsuda
Hitoshi
H
Minatoya
Kenji
K
Sasaki
Hiroaki
H
Yagihara
Toshikatsu
T
Kitamura
Soichiro
S
D058186:Acute Kidney Injury / Q000209:etiology; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D001013:Aorta, Thoracic / Q000473:pathology / Q000601:surgery*; D001799:Blood Sedimentation; D019917:Blood Vessel Prosthesis Implantation / Q000706:statistics & numerical data; D002097:C-Reactive Protein / Q000032:analysis; D003131:Combined Modality Therapy; D003251:Constriction, Pathologic; D004108:Dilatation, Pathologic / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D020925:Hypoxia-Ischemia, Brain / Q000517:prevention & control; D007238:Infarction / Q000209:etiology; D007431:Intraoperative Complications / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D010477:Perfusion; D011183:Postoperative Complications / Q000401:mortality; D012189:Retrospective Studies; D013116:Spinal Cord / Q000098:blood supply; D013625:Takayasu Arteritis / Q000097:blood / Q000188:drug therapy / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome
D000305:Adrenal Cortex Hormones; D000893:Anti-Inflammatory Agents; D002097:C-Reactive Protein