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Long-term outcomes and prognostic factors after aortic valve surgery in patients with Takayasu arteritis

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A Correction to this article was published on 14 January 2023

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Abstract

Background

Aortic regurgitation (AR) is a common cardiovascular complication in patients with Takayasu arteritis (TAK), and complication after aortic valve surgery (AVS) is not rare. This study aimed to identify the long-term postoperative outcomes for significant AR in patients with TAK compared with those in patients without TAK.

Methods

We included 35 patients with TAK with moderate-to-severe AR who underwent AVS and compared their postoperative outcomes with those of 105 age- and operation period-matched patients with severe AR but without TAK. The risk factors for poor outcomes [all-cause death and major adverse cardiac and cerebrovascular events (MACCE)] in patients with TAK were analyzed using multivariate Cox regression.

Results

The 10-year overall survival rate was 70.5% in patients with TAK and 89.4% in those without TAK (p = 0.048). The MACCE and reoperation rates were significantly higher in patients with TAK (10-year freedom from MACCE, 58.2% vs. 86.4% [p < 0.001]; 10-year freedom from reoperation, 64.5% vs. 98.3% [p < 0.001]). Eighteen of the 35 patients with TAK (51.4%) had poor outcomes, and multivariate analysis revealed that significant coronary artery involvement [hazard ratio (HR), 4.178; 95% confidence interval (CI), 1.222–14.282; p = 0.023] and decreased estimated glomerular filtration rate (HR, 0.968; 95% CI 0.947–0.989; p = 0.003) were associated with poor outcomes.

Conclusion

The long-term postoperative outcomes for AR were poorer in patients with TAK than in those without TAK. The poor outcomes in patients with TAK were associated with coronary artery involvement and decreased renal function.

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Data availability statement

All data generated or analyzed during this study are included in this article and its online supplementary material files. Further enquiries can be directed to the corresponding author.

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Funding

The authors received no financial support for the research, authorship, and/or publication of this article.

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Author notes

  1. So Hye Nam and Jino Park equally contributed to this work.

Authors and Affiliations

  1. Division of Rheumatology, Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, 88, Olympic-Ro 43-Gil, Songpa-Gu, Seoul, 05505, Korea

    So Hye Nam, Seokchan Hong, Yong-Gil Kim, Bin Yoo & Chang-Keun Lee

  2. Division of Rheumatology, Department of Internal Medicine, Eulji University School of Medicine, Uijeongbu Eulji Medical Center, Uijeongbu, Gyeonggi-Do, Korea

    So Hye Nam

  3. Department of Cardiology, Heart Institute, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-Ro 43-Gil, Songpa-Gu, Seoul, 05505, Korea

    Jino Park & Dae-Hee Kim

  4. Division of Cardiology, Department of Internal Medicine, Haeundae Paik Hospital, University of Inje College of Medicine, Busan, Korea

    Jino Park

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Contributions

The followings are the authors’ contribution: conceptualization: Kim DH and LCK; data curation: NSH; formal analysis: PJ; methodology: HS, KYG, and YB; writing—original draft: NSH and PJ; and writing—review and editing: KDH and LCK.

Corresponding authors

Correspondence to Chang-Keun Lee or Dae-Hee Kim.

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Conflict of interest

The authors have no financial conflicts of interest to disclose.

Ethical approval

This study was approved by the institutional review board of Asan Medical Center in Seoul, South Korea (approval no. 2017-0922). The requirement for informed consent was waived because of the retrospective nature of the study.

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Nam, S.H., Park, J., Hong, S. et al. Long-term outcomes and prognostic factors after aortic valve surgery in patients with Takayasu arteritis. Gen Thorac Cardiovasc Surg 71, 375–383 (2023). https://doi.org/10.1007/s11748-022-01893-5

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