Clinical characteristic of aortitis in cardiac surgery in a single center_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

LIU Junjiang , YUAN Li , YANG Quanlin , LIU Huan , ZHANG Hongqiang , YANG Shouguo , LAI Hao ,  SUN Xiaoning ,  WANG Chunsheng

Department of Cardiac Surgery, Zhongshan Hospital, Fudan University, Shanghai, 200032, P. R. China;

Corresponding author：

SUN Xiaoning, Email: Sun.xiaoning@zs-hospital.sh.cn; WANG Chunsheng, Email: Wang.Chunsheng@zs-hospital.sh.cn

Keywords：

Aortitis; Takayasu's arteritis; Behcet's disease; syphilitic aortitis

DOI：

10.7507/1007-4848.202201058

Video：

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Objective To review and analyze the clinical manifestations of common aortitis in cardiac surgery. Methods We screened 41 552 patients who were hospitalized in the Department of Cardiac Surgery of Zhongshan Hospital, Fudan University from 2010 to 2020, analyzed the patients' clinical data, and classified according to the type of diseases. Then we summarized all their clinical manifestations. Results In our center 145 patients were operated for aortitis diseases, including 75 males and 70 females, with the age of 24-76 (45.6±11.3) years. There were 61 patients of Takayasu's arteritis, 51 patients of Behcet's disease, 8 patients of syphilitic aortitis, 8 patients of systemic lupus erythematosus, 2 patients of Kawasaki disease, 4 patients of ankylosing spondylitis, 10 patients of dry syndrome, and 1 patient of scleroderma. Conclusion Aortitis is not uncommon in cardiac surgery, and awareness of the disease should be enhanced. So that we can distinguish various types of aortitis and to make proper management to improve patients' prognosis.

Citation： LIU Junjiang, YUAN Li, YANG Quanlin, LIU Huan, ZHANG Hongqiang, YANG Shouguo, LAI Hao, SUN Xiaoning, WANG Chunsheng. Clinical characteristic of aortitis in cardiac surgery in a single center. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2023, 30(9): 1290-1294. doi: 10.7507/1007-4848.202201058 Copy

1.	Marvisi C, Accorsi Buttini E, Vaglio A. Aortitis and periaortitis: The puzzling spectrum of inflammatory aortic diseases. Presse Med, 2020, 49(1): 104018.
2.	Sharma S, Pandey NN, Sinha M, et al. Etiology, diagnosis and management of aortitis. Cardiovasc Intervent Radiol, 2020, 43(12): 1821-1836.
3.	Hatemi G, Seyahi E, Fresko I. et al. One year in review 2020: Behçet's syndrome. Clin Exp Rheumatol, 2020, 38 Suppl 127(5): 3-10.
4.	Karadag O, Bolek EC. Management of Behcet's syndrome. Rheumatology (Oxford), 2020, 59(Suppl 3): Ⅲ108-Ⅲ117.
5.	孙立忠, 刘永民, 胡盛寿, 等. 大动脉炎导致主动脉瓣关闭不全的外科治疗. 中华胸心血管外科杂志, 2003, 19(3): 129-130.
6.	李明, 孙立忠, 常谦, 等. 白塞氏病致主动脉瓣关闭不全的外科治疗. 中国医学科学院学报, 2005, 27(3): 367-369.
7.	Marzban M, Mandegar MH, Karimi A, et al. Cardiac and great vessel involvement in "Behcet's disease". J Card Surg, 2008, 23(6): 765-768.
8.	Danda D, Goel R, Joseph G, et al. Clinical course of 602 patients with Takayasu's arteritis: Comparison between childhood-onset versus adult onset disease. Rheumatology (Oxford), 2021, 60(5): 2246-2255.
9.	Cong XL, Dai SM, Feng X, et al. Takayasu's arteritis: Clinical features and outcomes of 125 patients in China. Clin Rheumatol, 2010, 29(9): 973-981.
10.	Mednick Z, Farmer J, Khan Z, et al. Coronary arteritis: An entity to be considered in giant cell arteritis. Can J Ophthalmol, 2016, 51(1): e6-e8.
11.	Godoy P, Araújo Sde A, Paulino E, et al. Coronary giant cell arteritis and acute myocardial infarction. Arq Bras Cardiol, 2007, 88(4): e84-e87.
12.	de Boysson H, Espitia O, Samson M, et al. Giant cell arteritis-related aortic dissection: A multicenter retrospective study. Semin Arthritis Rheum, 2021, 51(2): 430-435.
13.	Dejaco C, Ramiro S, Duftner C, et al. EULAR recommendations for the use of imaging in large vessel vasculitis in clinical practice. Ann Rheum Dis, 2018, 77(5): 636-643.
14.	Embrey RP. Modified Cabrol's technique for composite replacement of the aortic valve and ascending aorta. J Card Surg, 1993, 8(5): 562-566.
15.	Ma WG, Zheng J, Zhu JM, et al. Aortic regurgitation caused by Behçet's disease: Surgical experience during an 11-year period. J Card Surg, 2012, 27(1): 39-44.
16.	Ghang B, Kim JB, Jung SH, et al. Surgical outcomes in Behcet's disease patients with severe aortic regurgitation. Ann Thorac Surg, 2019, 107(4): 1188-1194.
17.	吴锡阶, 卢琳, 严亮亮, 等. 白塞病患者主动脉瓣关闭不全的外科治疗策略. 中华胸心血管外科杂志, 2018, 34(10): 589-592.
18.	Ando M, Sasako Y, Okita Y, et al. Valved conduit operation for aortic regurgitation associated with Behçet's disease. Jpn J Thorac Cardiovasc Surg, 2000, 48(7): 424-427.
19.	Chen LW, Wu XJ, Cao H, et al. Valved conduit attached to left ventricular outflow tract for valve detachment in Behçet's disease. Ann Thorac Surg, 2017, 103(3): e301-e303.
20.	Roberts WC, Barbin CM, Weissenborn MR, et al. Syphilis as a cause of thoracic aortic aneurysm. Am J Cardiol, 2015, 116(8): 1298-1303.
21.	Roberts WC, Kondapalli N. Operative recognition of syphilis of the aorta. Am J Cardiol, 2018, 122(5): 898-904.
22.	Ballocca F, D'Ascenzo F, Moretti C, et al. Predictors of cardiovascular events in patients with systemic lupus erythematosus (SLE): A systematic review and meta-analysis. Eur J Prev Cardiol, 2015, 22(11): 1435-1441.
23.	Jia E, Geng H, Liu Q, et al. Cardiac manifestations of Han Chinese patients with systemic lupus erythematosus: A retrospective study. Ir J Med Sci, 2019, 188(3): 801-806.
24.	Shchetynska-Marinova T, Amendt K, Sadick M, et al. Aortitis—An interdisciplinary challenge. In Vivo, 2021, 35(1): 41-52.

1. Marvisi C, Accorsi Buttini E, Vaglio A. Aortitis and periaortitis: The puzzling spectrum of inflammatory aortic diseases. Presse Med, 2020, 49(1): 104018.
2. Sharma S, Pandey NN, Sinha M, et al. Etiology, diagnosis and management of aortitis. Cardiovasc Intervent Radiol, 2020, 43(12): 1821-1836.
3. Hatemi G, Seyahi E, Fresko I. et al. One year in review 2020: Behçet's syndrome. Clin Exp Rheumatol, 2020, 38 Suppl 127(5): 3-10.
4. Karadag O, Bolek EC. Management of Behcet's syndrome. Rheumatology (Oxford), 2020, 59(Suppl 3): Ⅲ108-Ⅲ117.
5. 孙立忠, 刘永民, 胡盛寿, 等. 大动脉炎导致主动脉瓣关闭不全的外科治疗. 中华胸心血管外科杂志, 2003, 19(3): 129-130.
6. 李明, 孙立忠, 常谦, 等. 白塞氏病致主动脉瓣关闭不全的外科治疗. 中国医学科学院学报, 2005, 27(3): 367-369.
7. Marzban M, Mandegar MH, Karimi A, et al. Cardiac and great vessel involvement in "Behcet's disease". J Card Surg, 2008, 23(6): 765-768.
8. Danda D, Goel R, Joseph G, et al. Clinical course of 602 patients with Takayasu's arteritis: Comparison between childhood-onset versus adult onset disease. Rheumatology (Oxford), 2021, 60(5): 2246-2255.
9. Cong XL, Dai SM, Feng X, et al. Takayasu's arteritis: Clinical features and outcomes of 125 patients in China. Clin Rheumatol, 2010, 29(9): 973-981.
10. Mednick Z, Farmer J, Khan Z, et al. Coronary arteritis: An entity to be considered in giant cell arteritis. Can J Ophthalmol, 2016, 51(1): e6-e8.
11. Godoy P, Araújo Sde A, Paulino E, et al. Coronary giant cell arteritis and acute myocardial infarction. Arq Bras Cardiol, 2007, 88(4): e84-e87.
12. de Boysson H, Espitia O, Samson M, et al. Giant cell arteritis-related aortic dissection: A multicenter retrospective study. Semin Arthritis Rheum, 2021, 51(2): 430-435.
13. Dejaco C, Ramiro S, Duftner C, et al. EULAR recommendations for the use of imaging in large vessel vasculitis in clinical practice. Ann Rheum Dis, 2018, 77(5): 636-643.
14. Embrey RP. Modified Cabrol's technique for composite replacement of the aortic valve and ascending aorta. J Card Surg, 1993, 8(5): 562-566.
15. Ma WG, Zheng J, Zhu JM, et al. Aortic regurgitation caused by Behçet's disease: Surgical experience during an 11-year period. J Card Surg, 2012, 27(1): 39-44.
16. Ghang B, Kim JB, Jung SH, et al. Surgical outcomes in Behcet's disease patients with severe aortic regurgitation. Ann Thorac Surg, 2019, 107(4): 1188-1194.
17. 吴锡阶, 卢琳, 严亮亮, 等. 白塞病患者主动脉瓣关闭不全的外科治疗策略. 中华胸心血管外科杂志, 2018, 34(10): 589-592.
18. Ando M, Sasako Y, Okita Y, et al. Valved conduit operation for aortic regurgitation associated with Behçet's disease. Jpn J Thorac Cardiovasc Surg, 2000, 48(7): 424-427.
19. Chen LW, Wu XJ, Cao H, et al. Valved conduit attached to left ventricular outflow tract for valve detachment in Behçet's disease. Ann Thorac Surg, 2017, 103(3): e301-e303.
20. Roberts WC, Barbin CM, Weissenborn MR, et al. Syphilis as a cause of thoracic aortic aneurysm. Am J Cardiol, 2015, 116(8): 1298-1303.
21. Roberts WC, Kondapalli N. Operative recognition of syphilis of the aorta. Am J Cardiol, 2018, 122(5): 898-904.
22. Ballocca F, D'Ascenzo F, Moretti C, et al. Predictors of cardiovascular events in patients with systemic lupus erythematosus (SLE): A systematic review and meta-analysis. Eur J Prev Cardiol, 2015, 22(11): 1435-1441.
23. Jia E, Geng H, Liu Q, et al. Cardiac manifestations of Han Chinese patients with systemic lupus erythematosus: A retrospective study. Ir J Med Sci, 2019, 188(3): 801-806.
24. Shchetynska-Marinova T, Amendt K, Sadick M, et al. Aortitis—An interdisciplinary challenge. In Vivo, 2021, 35(1): 41-52.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Clinical characteristic of aortitis in cardiac surgery in a single center

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