Histological pattern of non-infectious thoracic aortitis impacts mortality

Area of Science:

• Cardiovascular Surgery
• Pathology
• Epidemiology

Background:

• Non-infectious aortitis presents diverse histological subtypes.
• The long-term cardiovascular outcomes for these subtypes are not well-defined.
• Understanding these outcomes is crucial for patient management.

Purpose of the Study:

• To assess mortality rates in patients undergoing thoracic aortic surgery for non-infectious aortitis.
• To compare outcomes between different histological patterns of aortitis.
• To identify predictors of mortality in this patient cohort.

Main Methods:

• Retrospective analysis of a multicenter cohort of patients with histological evidence of aortitis undergoing thoracic aortic surgery.
• Categorization of patients into granulomatous/giant cell or lymphoplasmacytic histological patterns.
• Multivariate analysis to determine factors associated with mortality.

Main Results:

• The study included 197 patients with non-infectious aortitis (138 granulomatous/giant cell, 59 lymphoplasmacytic).
• Overall 10-year mortality was 31.5%, with 31% of deaths attributed to aortic dissection or rupture.
• The 10-year cumulative incidence of death was significantly higher for the granulomatous/giant cell pattern (40.1%) compared to the lymphoplasmacytic pattern (14.4%).

Conclusions:

• Non-infectious surgical thoracic aortitis is associated with a substantial 10-year mortality risk.
• The granulomatous/giant cell histological pattern independently predicts increased mortality.
• Aortic dissection at diagnosis is also a significant predictor of poor outcomes.