Background: Aortic regurgitation (AR) is a common
cardiovascular complication in patients with Takayasu arteritis (TAK),
and complication after aortic valve surgery (AVS) is not rare. This
study aimed to identify the long-term postoperative outcomes for
significant AR in patients with TAK compared with those in patients
without TAK. Methods: We included 35 patients with TAK with
moderate-to-severe AR who underwent AVS and compared their postoperative
outcomes with those of 105 age- and operation period-matched patients
with severe AR but without TAK. The risk factors for poor outcomes
(all-cause death and major adverse cardiac and cerebrovascular events
[MACCE]) in patients with TAK were analyzed using multivariate Cox
regression. Results: The 10-year overall survival rate was
70.5% in patients with TAK and 89.4% in those without TAK (p = 0.048).
The MACCE and reoperation rates were significantly higher in patients
with TAK (10-year freedom from MACCE, 58.2% vs. 86.4% [p <
0.001]; 10-year freedom from reoperation, 64.5% vs. 98.3% [p
< 0.001]). Eighteen of the 35 patients with TAK (51.4%) had
poor outcomes, and multivariate analysis revealed that significant
coronary artery involvement (hazard ratio [HR], 4.178; 95%
confidence interval [CI], 1.222–14.282; p = 0.023) and decreased
estimated glomerular filtration rate (HR, 0.968; 95% CI, 0.947–0.989;
p = 0.003) were associated with poor outcomes. Conclusion: The
long-term postoperative outcomes for AR were poorer in patients with TAK
than in those without TAK. The poor outcomes in patients with TAK were
associated with coronary artery involvement and decreased renal
function.