Abstract
Objective: Takayasu’s arteritis is an inflammatory vascular disease of unknown etiology that affects the aorta and its main branches, requiring surgical intervention due to occlusive lesions. We studied early and late surgical results. Methods: Between 1979 and December 1998,46 patients — 1 man and 45 women aged 15 to 72 years (mean: 46 ± 13 years) — with occlusive lesions caused by Takayasu’s arteritis underwent surgery. Preoperative steroids were administered to 22 patients having inflammation. Diagnosis indicating surgery included obstructive cervical vessel disease in 13 patients, obstructive coronary artery disease in 19, aortic coarctation in 15, and abdominal branch stenosis in 3. Surgical procedures involved bypass grafting in 31 (cervical vessel bypass in 13, ascending-abdominal aortic bypass in 4, axillary artery-abdominal aortic bypass in 10, descending-abdominal aortic bypass in 1, abdominal branch bypass in 3), coronary artery bypass grafting in 10, and coronary ostial endarterectomy in 9. Results: Four (8.7%) died during hospitalization. Follow-up ranged from 1 to 240 months (mean: 117 months). Eight suffered late deaths and 6 patients died of cardiovascular problems. The total actuarial survival rate was 76.2% at 5 years and 70.5% at 10 years. Conclusions: Steroid therapy before and after surgery appears to affect the overall prognosis positively in patients with Takayasu’s arteritis.
Similar content being viewed by others
References
Takagi A, Tada Y, Sato O, Miyata T. Surgical treatment for Takayasu’s arteritis: A long-term follow-up study. J Cardiovasc Surg 1989; 30: 553–8.
Kimoto S. The history and present status of aortic surgery in Japan particularly for aortitis syndrome. J Cardiovasc Surg 1979; 20: 107–26.
DuCailar C, Thurmond A, Semler H, Starr A. Aortic valve replacement for acute Takayasu’s disease. Ann Thorac Surg 1987; 43: 102–4.
Suzuki A, Amano J, Tanaka H, Sakamoto T, Sunamori M. Surgical consideration of aortitis involving the aortic root. Circulation 1989; 80 (Suppl I): I–222-32.
Takayasu M. A case with unusual changes of the central vessels in the retina (in Japanese). Acta Soc Ophth Jap 1908; 12: 554–5.
Lupi-Herrera E, Sanchez-Torres G, Marcushamer J, Mispireta J, Horwitz S, Vela JE. Takayasu’s arteritis. Clinical study of 107 cases. Am Heart J 1977; 93: 94–103.
Young JA, Sengupta A, Khaja FU. Coronary arterial stenosis, angina pectoris, and atypical coarctation of the aorta due to nonspecific arteritis. Treatment with aortocoronary bypass graft. Am J Cardiol 1973; 32: 356–60.
Cipriano PR, Silverman JF, Perlroth MG, Griepp RB, Wexler L. Coronary arterial narrowing in Takayasu’s aortitis. Am J Cardiol 1977; 39: 744–50.
Makino N, Orita Y, Takeshita A, Nakamura M, Matsui K, Tokunaga K. Coronary arterial involvement in Takayasu’s disease. Jpn Heart J 1982; 23: 1007–13.
Ohara K, Kasegawa H, Ando M, Kawazoe K, Kosakai Y, Kaku K, et al. Surgical treatment for coronary artery disease associated with aortitis syndrome. Jpn J Thorac Surg 1986; 39: 423–8.
Ishikawa K, Maetani S. Long-term outcome for 120 Japanese patients with Takayasu’s disease: clinical and statistical analyses of related prognostic factors. Circulation 1994; 90: 1855–60.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Ando, M., Sasako, Y., Okita, Y. et al. Surgical considerations of occlusive lesions associated with Takayasu’s arteritis. Jpn J Thorac Caridovasc Surg 48, 173–179 (2000). https://doi.org/10.1007/BF03218116
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF03218116