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Aortic regurgitation (AR) is when the aortic valve does not close or seal properly, leading to backward blood circulation from the aorta into the left ventricle during diastole. Common causes of AR include rheumatic heart disease, congenital valve defects, and aortic root dilation. Managing AR requires a multifaceted approach to alleviate symptoms, preserve left ventricular function, and address the underlying cause of the regurgitation. Patients with symptomatic AR or significant left...
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[Aortitis and surgery].

J Gaudric1, M Dennery1, C Jouhannet1

  • 1Service de chirurgie vasculaire, hôpital Pitié-Salpêtrière, 47-83, boulevard de l'Hôpital, 75013 Paris, France.

La Revue De Medecine Interne
|January 23, 2016
PubMed
Summary
This summary is machine-generated.

Non-infectious aortitis, including giant cell arteritis, requires inflammation control before surgery. While endovascular treatments may lower immediate risks, long-term complications persist in these aortic diseases.

Keywords:
AortiteAortitisArtérite gigantocellulaireBehçet's diseaseChirurgieGiant cell arteritisMaladie de BehçetMaladie de HortonMaladie de TakayasuSurgeryTakayasu diseaseTemporal arteritis

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Area of Science:

  • Vascular Surgery
  • Rheumatology
  • Cardiology

Background:

  • Non-infectious aortitis commonly stems from giant cell arteritis (temporal arteritis), Takayasu disease, and Behçet's disease.
  • Aortitis suspicion arises from aortic wall thickening, aneurysm, or occlusion without typical cardiovascular risk factors.

Purpose of the Study:

  • To review the management of non-infectious aortitis, focusing on surgical and endovascular treatment strategies.
  • To highlight the importance of inflammatory disease quiescence before intervention and discuss long-term outcomes.

Main Methods:

  • Literature review of non-infectious aortitis management.
  • Analysis of surgical and endovascular treatment outcomes, including complications.

Main Results:

  • Severe aortic damage necessitates surgical intervention.
  • Pre-operative control of inflammation is crucial to prevent complications like anastomotic false aneurysm and stent thrombosis.
  • Giant cell arteritis warrants systematic screening for aortic aneurysms, particularly in the ascending aorta.
  • Behçet's and Takayasu diseases demand stringent inflammation control and specialized surgical techniques to prevent recurrence.
  • Endovascular treatment may reduce perioperative morbidity but does not significantly decrease long-term complications.

Conclusions:

  • Effective management of non-infectious aortitis requires a multidisciplinary approach, prioritizing inflammation control.
  • While endovascular options exist, careful patient selection and long-term monitoring are essential due to persistent complication risks.