Surgical Outcome of Takayasu Arteritis: Postoperative Cardiovascular Events Study

Abstract

Hiroshi Furuhata, Manabu Shiraishi*, Kenichiro Sato and Atsushi Yamaguchi

Objective: Takayasu’s arteritis develops at a younger age than other vascular diseases secondary to atherosclerosis. It was associated with more reoperations and cardiovascular events in the late postoperative period. This study aimed to clarify the surgical and late postoperative outcomes of Takayasu’s arteritis.

Methods: Twenty-seven patients, who underwent surgery for Takayasu’s arteritis at the Saitama Medical Center, Jichi Medical University, between February 1996 and November 2021, were included. The patient’s ages ranged from 27 to 80 years. There were four males and 23 females. There were four patients with type I disease, ten with type II a disease, four with type II b disease, zero with type III disease, six with type IV disease, and three with type V disease. The surgical outcomes, survival rates, and late postoperative cardiovascular events were evaluated.

Results: Five patients underwent coronary artery bypass surgery, 16 underwent valvuloplasty and valve replacement, five underwent thoracic aortic replacement, three underwent abdominal aortic replacement, five underwent thoracic aortic replacement, three underwent abdominal aortic replacement, and six underwent peripheral arterial bypass surgery. The mean follow-up period was 9.1 ± 7.6 years. There was one inhospital death and three remote deaths. Late postoperative cardiovascular events occurred in 14 patients. In particular, there were four patients with coronary lesions requiring percutaneous coronary intervention, five with heart failure, two who suffered a stroke, one with a cerebral aneurysm, one with arrhythmia requiring ablation, and two with pacemaker implantation. The 10-year survival rate was 78.0%, while the 10-year event-free survival was 25.2%. The 10-year event-free survival, excluding perioperative complications, was 54.4%.

Conclusion: Late postoperative cardiovascular events occurred in approximately half of the patients during the follow-up period. Patients, suspected of Takayasu’s arteritis, should be monitored for the development of new vascular lesions to establish an accurate postoperative diagnosis.