Evaluation of the results of surgical treatment for dilative lesions associated with Takayasu's arteritis

Abstract

Takayasu's arteritis is a disease of unknown etiology that affects the aorta and its main branches, and requires surgical intervention because of dilative lesions. We investigated the surgical results. Between 1979 and June 1999, 87 patients with dilative lesions associated with Takayasu's arteritis underwent surgery. There were 7 males and 80 females. The age of these patients ranged from 15 years to 76 years (mean, 49 ± 13 years). Preoperative steroids were administered to 40 patients who presented with inflammatory findings. Diagnoses which needed a operation were thoracic aortic aneurysm (TAA) in 43 patients, and diffuse dilatation of the ascending aorta with aortic regurgitation (AR) in 44. Operations performed for TAA were ascending aortic grafting in 25 patients, ascending-aortic arch grafting in 6, descending-abdominal aortic grafting in 5, and other aortic grafting in 7. Operations performed for dilatation of the aorta with AR were aortic value replacement (AVR) in 42 patients, valved conduit reconstruction in 2. Five patients (5.7%) died during the hospital stay. The follow-up period in 82 patients who survived the surgery ranged from 1 month to 246 months (mean, 107 ± 73 months). There were 15 patients of late deaths, and 10 patients died due to cardiovascular problems. The total actuarial survival rate was 79.7% at 6 years and 74.3% at 9 years. Steroid therapy before and after surgery seems to positively affect the overall prognosis of patients with Takayasu's arteritis.