Surgical management of Takayasu's arteritis in children and adolescents.

UNLABELLED: There is little information on the surgical management of Takayasu's arteritis in children and adolescents. Information on 30 patients aged between eight and 17 years was culled from a prospectively maintained database on the Vascular Service of the University of KwaZulu-Natal, Durban, South Africa. Twenty-one patients had involvement of the descending aorta; in 19, this was confined to the aorta (type 2 disease). One had associated arch disease (type 3) and one had associated cardiac disease (type 4). One patient had isolated axillary artery occlusion (type 5). Eight patients had disease confined to the aortic arch (type 1), 22 had occlusive disease and eight were aneurysmal. All patients had operative repairs undertaken. There were no peri-operative deaths in the group who had cerebrovascular reconstruction, and one death (4.5%) in those who had descending aortic replacement. Patients were followed up for between one month and 11 years. Hypertension was improved or cured in 10 of 12 patients. Two died during this period and another five patients (20%) required further surgery for stenosis (three patients) or anastomotic aneurysms (two).
CONCLUSION: Bypass surgery yields satisfactory results in this age group in terms of peri-operative and medium-term mortality and morbidity.