Surgical treatment for aortic regurgitation caused by non-specific aortitis

Aortic regurgitation caused by non-specific aortitis is relatively rare, an d prosthetic valve detachment after aortic valve replacement has been repor ted to be one of the most serious complications. The authors investigated t he surgical results in patients with aortic regurgitation caused by non-spe cific aortitis. Between 1978 and 1997, 90 patients with aortic regurgitatio n secondary to non-specific aortitis underwent surgery. There were 28 males and 62 females. The age of these patients ranged from 19 years to 70 years (mean, 48 years). Sixty-five patients were diagnosed to have Takayasu's ar teritis, 10 had Behcet's disease and 15 had aortitis of unknown etiology. T he surgical procedures for aortic regurgitation were aortic valve replaceme nt in 62 patients, Bentall-type operation in 27 and remodeling in one. Five patients (5.6%) died during the hospital stay. The follow-up duration rang ed from 1 month to 224 months (mean, 98 months), Twenty-one patients died d uring the follow-up period, and the actuarial survival rate was 83% at 5 ye ars and 68% at 10 years, Prosthetic valve detachment occurred in 12 patient s (13.3%). Two patients required a re-aortic valve replacement, eight had a composite graft replacement and two patients underwent a homograft reconst ruction, Absence of prosthetic valve detachment was noted in 83% of the pat ients at 5 years and in 75% at 10 years, The incidence of prosthetic valve detachment was 40% (4/10) in patients with Behcet's disease, 33% (5/15) in aortitis of unknown etiology, 4.6% (3/65) in Takayasu's arteritis and 29% ( 8/28) in male patients. Surgical techniques for treatment of this condition should be modified for further improvement of the surgical outcome in thes e patients with Behcet's disease and aortitis of unknown etiology. (C) 1999 The International Society for Cardiovascular Surgery. Published by Elsevie r Science Ltd. All rights reserved.