To investigate the presentation, aortic involvement, and surgical outcomes in patients with Takayasu arteritis undergoing aortic surgery. We queried our surgical database for patients with Takayasu arteritis who underwent aortic surgery from 1994 to 2022. There were a total of 31 patients with Takayasu arteritis who underwent aortic surgery. Patients' median age at the time of diagnosis was 35.0 years (interquartile range, 25.0-42.0). The majority were female (n = 27, 87.0%). Most patients (n = 28, 90.3%) were diagnosed before surgery, and 3 patients (9.6%) were diagnosed perioperatively. The median time interval from diagnosis to surgery was 2.8 years (interquartile range, 0.5-13.9). The most common presentation was ascending aorta aneurysm (n = 22, 70.9%), and severe aortic regurgitation was the most common valve insufficiency (n = 17, 54.8%). The most common operation was ascending aorta replacement (n = 20, 64.5%), and aortic valve replacement was the most common valve intervention (n = 17, 54.8%). Active vasculitis was identified in 2 (11.7%) aortic valve specimens. Early mortality was 6.5% (n = 2). A total of 6 deaths occurred over a median follow-up of 13.1 years (interquartile range, 6.1-25.2). Survival at 10 years was 86.7% (95% CI, 75.4-99.7). A total of 5 patients (16.1%) required a subsequent operation in a median of 1.9 years (interquartile range, 0.2-7.4). Freedom from reoperation was 96.9% (95% CI, 90.1-100) at 1 year, 89.4% (95% CI, 78.7-100.0) at 5 years, and 77.5% (95% CI, 61.2-98.1) at 10 and 15 years. Ascending aorta aneurysm and aortic valve regurgitation are the most frequent presentations in patients with Takayasu arteritis requiring aortic surgery. Surgery in these individuals is safe, with acceptable short- and long-term results.

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大动脉炎患者主动脉手术的结果

旨在调查接受主动脉手术的大动脉炎患者的表现、主动脉受累和手术结果。我们查询了1994年至2022年接受主动脉手术的大动脉炎患者的手术数据库。共有31名接受主动脉手术的大动脉炎患者。患者诊断时的中位年龄为 35.0 岁（四分位数范围，25.0-42.0）。大多数为女性（n = 27, 87.0%）。大多数患者（n = 28，90.3%）在术前诊断，3例患者（9.6%）在围手术期诊断。从诊断到手术的中位时间间隔为 2.8 年（四分位数范围，0.5-13.9）。最常见的表现是升主动脉瘤（n = 22，70.9%），严重主动脉瓣关闭不全是最常见的瓣膜关闭不全（n = 17，54.8%）。最常见的手术是升主动脉置换术（n = 20，64.5%），主动脉瓣置换术是最常见的瓣膜介入治疗（n = 17，54.8%）。在 2 个（11.7%）主动脉瓣标本中发现活动性血管炎。早期死亡率为 6.5% (n = 2)。中位随访时间为 13.1 年（四分位数范围，6.1-25.2），共有 6 例死亡。10 年生存率为 86.7%（95% CI，75.4-99.7）。共有 5 名患者（16.1%）需要在中位 1.9 年（四分位距，0.2-7.4）内进行后续手术。1 年时免再手术率为 96.9%（95% CI，90.1-100），5 年时为 89.4%（95% CI，78.7-100.0），10 年和 15 年时为 77.5%（95% CI，61.2-98.1）年。升主动脉瘤和主动脉瓣关闭不全是需要主动脉手术的大动脉炎患者最常见的表现。这些人的手术是安全的，具有可接受的短期和长期结果。