| Surgical treatment of aortic regurgitation due to Takayasu arteritis: long-term morbidity and mortality. | |
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MedLine Citation:
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PMID: 16330687 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: The goal of this retrospective study was to determine the late outcome of surgical treatment for aortic valve regurgitation due to Takayasu arteritis and correlate it with evidence of inflammation on pathological examination. METHODS AND RESULTS: Ninety consecutive patients who underwent surgery for aortic valve regurgitation due to Takayasu arteritis between 1979 and 2003 were studied. Intraoperative pathological specimens of the aortic wall from 69 patients were retrospectively examined for inflammation. Aortic valve replacement was performed in 63 patients (group A) and composite graft repair in 27 patients (group B). The aortic root diameter was 39.9+/-9.5 mm in group A and 54.4+/-13.6 mm in group B (P<0.0001). Preoperative steroid therapy was performed in 40 patients (44.4%). Hospital mortality was 4.8% (3/63) in group A and 7.4% (2/27) in group B. The overall 15-year survival rate was 76.1%. Detachment of the valve or graft occurred in 11.1% (7/63) of group A and in 3.7% (1/27) of group B patients (P=0.43). Late dilatation (>50 mm) of the residual ascending aorta occurred in 11.1% (7/63) of group A and in 3.7% (1/27) of group B patients (P=0.43). Active inflammation was confirmed in intraoperative pathological specimens of 10 patients, and detachment of the valve or graft occurred in 4 of these patients. Univariate analysis of background variables revealed active inflammation to be a risk factor for detachment (P=0.0001; risk ratio 55). CONCLUSIONS: Late dilatation of the ascending aorta after aortic valve replacement is a clinically important finding. Active inflammation could be related to valve or graft detachment. |
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Authors:
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Kaoru Matsuura; Hitoshi Ogino; Junjiro Kobayashi; Hatsue Ishibashi-Ueda; Hitoshi Matsuda; Kenji Minatoya; Hiroaki Sasaki; Ko Bando; Kazuo Niwaya; Osamu Tagusari; Hiroyuki Nakajima; Toshikatsu Yagihara; Soichiro Kitamura |
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Publication Detail:
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Type: Journal Article Date: 2005-12-05 |
Journal Detail:
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Title: Circulation Volume: 112 ISSN: 1524-4539 ISO Abbreviation: Circulation Publication Date: 2005 Dec |
Date Detail:
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Created Date: 2005-12-13 Completed Date: 2006-02-21 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0147763 Medline TA: Circulation Country: United States |
Other Details:
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Languages: eng Pagination: 3707-12 Citation Subset: AIM; IM |
Affiliation:
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Department of Cardiovascular Surgery, National Cardiovascular Center, Suita, Osaka, Japan. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aortic Valve / pathology Aortic Valve Insufficiency / etiology, mortality, pathology, surgery* Cardiac Surgical Procedures Female Heart Valve Prosthesis Implantation Humans Inflammation / complications, pathology Male Middle Aged Morbidity Prosthesis Failure Retrospective Studies Risk Factors Steroids / therapeutic use Survival Analysis Takayasu Arteritis / complications*, mortality, pathology Treatment Outcome |
| Chemical | |
Reg. No./Substance:
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0/Steroids |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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