Current surgical approaches in Takayasu's arteritis: a single-centre experience

Area of Science:

• Vascular Surgery
• Cardiology
• Immunology

Background:

• Takayasu's arteritis (TAK) is a large-vessel vasculitis affecting the aorta and its branches.
• Cardiovascular manifestations of TAK often require surgical intervention.
• Optimal surgical strategies and outcomes in TAK patients remain under investigation.

Purpose of the Study:

• To evaluate cardiovascular surgical interventions in patients with Takayasu's arteritis.
• To assess the midterm outcomes, including graft patency and complications, of these interventions.

Main Methods:

• Retrospective study of 20 patients with TAK undergoing cardiovascular surgery between 2008 and 2016.
• Surgical procedures included coronary artery bypass grafting, aortic aneurysm repair, and revascularization of various arteries (aorta-iliac, femoral, renal, celiac, mesenteric).
• Follow-up data on graft patency, complications, and mortality were analyzed.

Main Results:

• A total of 32 grafts were placed; 12.5% occluded during a mean follow-up of 39.2 months.
• No operative mortality or anastomotic aneurysms were observed.
• Complications included graft infection (1 death), stroke (2 patients), and need for secondary interventions in 2 patients.

Conclusions:

• Cardiovascular surgery in TAK patients demonstrated relatively good midterm graft patency.
• No anastomotic pseudoaneurysms were observed, but complications like graft infection and stroke can occur.
• Endarterectomy may be considered for limited stenosis; multidisciplinary management is key for favorable outcomes.