ISSN : 1301-5680
e-ISSN : 2149-8156
Turkish Journal of Thoracic and Cardiovascular Surgery     
Aortic regurgitation and aortic valve operation in Takayasu arteritis: A meta-analysis
Shi-Min Yuan
Department of Cardiothoracic Surgery, The First Hospital of Putian, Teaching Hospital, Fujian Medical University, Putian, China
DOI : 10.5606/tgkdc.dergisi.2017.14654
Background: This study aims to describe the clinical features of aortic regurgitation, which can be a major complication of patients with Takayasu arteritis, as well as necessitated aortic valve operations in such patients.

Methods: This meta-analysis was based on the literature retrieval of 41 pertinent articles including 159 Takayasu arteritis patients, published between January 2001 and December 2016. There were 12 male and 55 female patients, while gender of 92 patients was not available.

Results: The aortic regurgitation patient profile of Takayasu arteritis population showed a predominance of female gender, type 2a of Takayasu arteritis, and severe degree of aortic regurgitation. Most of them warranted aortic valve operations, the most common of which were aortic valve replacements or composite graft replacements. Of the concurrent cardiac operations, coronary artery bypass grafting was the most frequent, for which the saphenous vein was a preferred graft choice due to the concern of the Takayasu arteritis-impaired arterial graft patency. Postoperative cardiac complications occurred in 31 patients (20.7%) and reintervention was warranted in 13 (41.9%). Logistic regression analysis revealed that the primary aortic valve operation and concurrent cardiac operation were the predictive risk factors of postoperative complications. The mortality rate of the entire patient population was 21.5%.

Conclusion: Takayasu arteritis may cause aortic regurgitation and the majority of the patients warrant an aortic valve operation. The postoperative comorbidity rate remains high. To avoid postoperative complications and subsequent reinterventions, utilization of reinforcing techniques during aortic valve operations, avoidance of cardiac operations during an active stage of Takayasu arteritis and postoperative steroid therapy are recommended.

Keywords : Aortic regurgitation; aortic valve replacement; Takayasu arteritis
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