Tie Zheng1, Shuai Zhu2, Jia-Fu Ou3, Wei-Gang Fang4, Zhi-Yu Qiao2, Rui-Dong Qi2, Li Chen2, Lei Chen2, Cheng-Nan Li2, Li-Li Pan5, Qing Zhu6, Dong Chen6, Xue-Jun Sun7, Jun-Ming Zhu8. 1. a Department of Cardiovascular Surgery , Beijing Aortic Disease Center, Beijing Anzhen Hospital, Capital Medical University, Beijing, China, Beijing Institute of Heart Lung and Blood Vessel Diseases, Beijing Engineering Research Center for Vascular Prostheses , Beijing , China. 2. b Department of Cardiovascular Surgery , Beijing Aortic Disease Center, Beijing Anzhen Hospital, Capital Medical University , Beijing , China ; Beijing Institute of Heart Lung and Blood Vessel Diseases , Beijing , China. 3. c Cardiology Division, Department of Internal Medicine , Washington University , St. Louis , USA. 4. d General Internal Medicine Unit , Peking Union Medical College Hospital, Peking Union Medical College , Chinese Academy of Medical Sciences , Beijing , China. 5. e Department of Rheumatology and Immunology Beijing Aortic Disease Center, Beijing Anzhen Hospital , Capital Medical University , Beijing , China ; Beijing Institute of Heart Lung and Blood Vessel Diseases , Beijing , China. 6. f Department of Pathology , Beijing Anzhen Hospital, Capital Medical University , Beijing , China. 7. g Department of Cardiovascular Surgery , Beijing Anzhen Hospital of Capital Medical University, Beijing Institute of Heart , Lung and Blood Vessel Diseases, and Beijing Engineering Research Center of Vascular Prostheses , Beijing , China ; Fu Wai Hospital and Cardiovascular Institute, Chinese Academy of Medical Sciences , Beijing , China. 8. h Department of General Surgery , The First Affiliated Hospital of Xi'an Jiaotong University , Xi'an , Shanxi , China.
Abstract
OBJECTIVE: To analyze the clinical outcome of corticosteroid and/or immunosuppressive treatment preoperatively in patients with Takayasu's arteritis. PATIENTS AND METHODS: Forty-six patients with Takayasu's arteritis who received cardiovascular surgery between January 2010 and December 2015 in Beijing Anzhen Hospital were enrolled in this study. Their clinical characteristics, preoperative drug therapy, surgical treatment, and pathological examination results were retrospectively analyzed for the effect of drugs on outcome of the surgery. RESULTS: All 8 patients with active disease prior to surgery had postoperative complications including one death due to stubborn perivalvular regurgitation induced heart failure during the perioperative period. Among 38 patients without active disease prior to surgery, only 4 patients (10.5%) had postoperative complications. Thirty-four patients showed symptomatic relief in the perioperative period, of whom 23 patients treated with corticosteroid and/or immunosuppressive agents preoperatively. CONCLUSION: The surgery can effectively improve the symptoms of patients with Takayasu's arteritis. Active disease of Takayasu's arteritis markedly increased risk for postoperative complication and resulted in poor outcome of the surgery. Treatment with corticosteroid and/or immunosuppressive agents before surgery can effectively control the patient's condition, improve the rate of remission, and effectively reduce the incidence of postoperative complications.
OBJECTIVE: To analyze the clinical outcome of corticosteroid and/or immunosuppressive treatment preoperatively in patients with Takayasu's arteritis. PATIENTS AND METHODS: Forty-six patients with Takayasu's arteritis who received cardiovascular surgery between January 2010 and December 2015 in Beijing Anzhen Hospital were enrolled in this study. Their clinical characteristics, preoperative drug therapy, surgical treatment, and pathological examination results were retrospectively analyzed for the effect of drugs on outcome of the surgery. RESULTS: All 8 patients with active disease prior to surgery had postoperative complications including one death due to stubborn perivalvular regurgitation induced heart failure during the perioperative period. Among 38 patients without active disease prior to surgery, only 4 patients (10.5%) had postoperative complications. Thirty-four patients showed symptomatic relief in the perioperative period, of whom 23 patients treated with corticosteroid and/or immunosuppressive agents preoperatively. CONCLUSION: The surgery can effectively improve the symptoms of patients with Takayasu's arteritis. Active disease of Takayasu's arteritis markedly increased risk for postoperative complication and resulted in poor outcome of the surgery. Treatment with corticosteroid and/or immunosuppressive agents before surgery can effectively control the patient's condition, improve the rate of remission, and effectively reduce the incidence of postoperative complications.