Surgical treatment for aortic regurgitation caused by Takayasu's arteritis.

Aortic regurgitation (AR) caused by Takayasu's arteritis is relatively rare. We investigated the surgical results in patients with AR caused by Takayasu's arteritis. Between 1978 and December 1997, 65 patients (5 males, 60 females) with AR secondary to Takayasu's arteritis underwent surgery. The patients' ages ranged from 19 to 70 years (mean, 48 years). Takayasu's arteritis was diagnosed by clinical examination confirmed by intraoperative pathological examination of the aortic wall. The surgical procedures for AR were aortic valve replacement in 45 patients, Bentall-type operation in 19, and remodeling in 1. Four (6.2%) patients died during the hospital stay. The follow-up period ranged from 3 to 227 months (mean, 111 months). Eleven patients died during the follow-up period, and the actuarial survival rate was 87% at 5 years and 75% at 10 years. The incidence of prosthetic valve detachment was 4.6% (3/65). Three patients required a composite graft replacement. No prosthetic valve detachment was noted in 96% of the patients at 5 years and in 94% at 10 years. Preoperative steroid administration to treat inflammation and its postoperative use to control inflammation may be important in the treatment of these patients.