Surgical management of aortic regurgitation associated with takayasu arteritis and other forms of aortitis.
BACKGROUND
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.


METHODS
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.


RESULTS
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.


CONCLUSIONS
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.
Department of Cardiovascular Surgery, Tohoku University Graduate School of Medicine, Sendai, Japan. oadachi@mail.tains.tohoku.ac.jp
Osamu
O
Adachi
Yoshikatsu
Y
Saiki
Junetsu
J
Akasaka
Katsuhiko
K
Oda
Atsushi
A
Iguchi
Koichi
K
Tabayashi
D000328:Adult; D000368:Aged; D001021:Aortic Valve / Q000601:surgery*; D001022:Aortic Valve Insufficiency / Q000401:mortality / Q000601:surgery*; D001025:Aortitis / Q000150:complications*; D005260:Female; D005500:Follow-Up Studies; D019918:Heart Valve Prosthesis Implantation / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D013625:Takayasu Arteritis / Q000150:complications*