Aortic Valve Replacement in a Patient with Takayasu's Disease without Cross-Clamping the Calcified Ascending Aorta

Abstract

The case of a 42-year-old female requiring surgical management of aortic regurgitation, secondary to Takayasu's disease, with a co-existing heavily calcified ascending aorta is described. In order to address aortic valve surgery with such calcific disease affecting the ascending aorta and peripheral vessels, we present a simple and safe technique that allows aortic valve replacement using a vascular intra-aortic occlusion catheter.

Aortic regurgitation and aortic valve operation in Takayasu arteritis: A meta-analysis

“…[14] By preoperative imaging, the left ventricular dimension was detected in 23 patients (14.5%). [11,13,14,17,24,27,[31][32][33][34]36,39,40,42] The end diastolic diameter of the left ventricle was normal in four patients (17.4%), [13,42] and left ventricular dilation was found in 19 patients (82.6%) [11,14,17,24,27,[31][32][33][34]36,39,40,42] (c 2 =19.6, p<0.001). The quantitative value of the end diastolic diameter of the left ventricle was 57.3±9.0 mm (range 44-72 mm; median 60 mm) (n=15).…”

“…[11,12,[19][20][21]23,27,30,40,47,48] A cardiac murmur was recorded in 17 patients (10.7%), including a diastolic murmur in 11 (74.7%), Yuan. Aortic regurgitation in Takayasu arteritis a systolic-diastolic murmur in four (23.5%), [13,14,17,36] a to-and-fro murmur in one (5.9%) [21] and an unspecified murmur in one (5.9%) (c 2 =20.9, p<0.001).…”

“…[12,14,15,20,23,24,28,[30][31][32]47] The degree of AR was not reported in 118 patients (74.2%). [10,16,18,22,26,35,38,45,50] In the remaining 41 patients (25.8%), one (2.4%) was mild, [29] nine (22.0%) were moderate, [11,12,23,34,37,41,42,49] one (2.4%) was moderate-to-severe [37] and 30 (73.2%) were severe [13][14][15]17,[19][20][21]24,25,27,28,[30][31][32][33]36,39,40,[42][43][44]…”

“…[48] In 33 patients (20.8%), the type of TA could be tracked: five (15.2%) were type 1, [28,33,34,37,47] 21 (63.6%) were type 2a, [11][12][13][14][17][18][19][20][21][22][23][24]27,29,30,36,38,39,46,48,49] one (3.0%) was type 2b, [31] three (9.1%) were type 3, [32,40,41] two (6.1%) were type 4, and one (3.0%) was type 5. [16] The activity of TA could be traced in 42 patients (26.4%): 37 (88.1%) were active [12,[14][15][16][18][19][20][21][22][23][24]26,28,[30][31][32]36,37,…”

“…[10][11][12]14,15,[17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][38][39][40]42,[44][45][46][47][48][49][50] The aortic valve operations that were performed in these patients were: aortic valve repair in three (2%) [12,30,32] (in one of them, aortic valve repair was performed after a three-week steroid treatment), [32] aortic valve replacement in 98 (65.3%), [10,11,14,17,18,20,[22][23][24][25]...…”