title: Surgery for aortic regurgitation and aortic root dilatation in Takayasu arteritis.
abstract: BACKGROUND
  Special consideration may be required for surgical treatment in Takayasu arteritis because inflammation may cause serious complications such as valve detachment or dilatation of the residual aorta. We evaluated our surgical outcome of treatment for aortic regurgitation and aortic root dilatation in Takayasu arteritis.
  
  
  METHODS
  Between December 1983 and January 2013, 22 cardiac operations were performed in 20 patients with aortic regurgitation due to Takayasu arteritis. Aortic valve replacement was carried out in 6 patients, and aortic root replacement in 16. Of these 16 patients, composite graft replacement was undertaken in 6, composite graft replacement plus coronary artery bypass grafting in 2, composite graft replacement plus total or partial arch replacement in 7, and valve-sparing aortic root replacement with hemiarch replacement in one.
  
  
  RESULTS
  The operative mortality (within 30 days) was 4.5% and the 5-year survival rate was 90.9%. Early surgical reintervention was not required in any patient. Neither valve detachment nor composite graft detachment was noted. Two patients required redo aortic root replacement due to pseudoaneurysm formation and severe aortic regurgitation during follow-up. Late dilatation of the residual thoracoabdominal or abdominal aorta was observed in 2 patients, and both were treated surgically.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Cardiovascular Surgery, Tokyo Women's Medical University Hospital, Tokyo, Japan yuji_1350@ybb.ne.jp.
authors.forename: Yuji
authors.initials: Y
authors.lastname: Kaku
authors.affiliation: Department of Cardiovascular Surgery, Tokyo Women's Medical University Hospital, Tokyo, Japan.
authors.forename: Shigeyuki
authors.initials: S
authors.lastname: Aomi
authors.affiliation: Department of Cardiovascular Surgery, Tokyo Women's Medical University Hospital, Tokyo, Japan.
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Tomioka
authors.affiliation: Department of Cardiovascular Surgery, Tokyo Women's Medical University Hospital, Tokyo, Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Yamazaki
mesh_terms: D000328:Adult; D001014:Aortic Aneurysm / Q000175:diagnosis / Q000209:etiology / Q000401:mortality / Q000601:surgery*; D001022:Aortic Valve Insufficiency / Q000175:diagnosis / Q000209:etiology / Q000401:mortality / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000401:mortality; D005260:Female; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects / Q000401:mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000601:surgery; D012086:Reoperation; D012189:Retrospective Studies; D012307:Risk Factors; D013625:Takayasu Arteritis / Q000150:complications / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
keywords: Aortic arch syndromes; Aortic valve insufficiency; Arteritis; Heart valve prosthesis implantation; Takayasu arteritis; Treatment outcome