Connective tissue disease: an important cause of reoperation of aorta

Abstract

Objective To investigate the clinical characteristics and surgical treatment experience of reoperation of aorta caused by connective tissue disease. Methods The perioperative and follow-up data of 45 patients with reoperation of aorta in our department from January 2010 to December 2019 were collected and retrospectively analyzed. They were 33 males and 12 females, at an age from 9~73 (46.0±14.1) years. There were 19 cases of connective tissue disease, including 9 cases of Behcet's disease, 4 cases of Marfan's syndrome and 6 cases of bicuspid aortic valve. Bentall operation was performed in 24 cases, Bentall+total aortic arch replacement+descending aortic stent elephant trunk operation in 6 cases, Bentall+mitral valve replacement in 5 cases, and other types of operation in 10 cases. All the patients were followed up for 17~113 (58.5±25.6) months. Results Reoperation of aorta was quite rare, only accounting for 7.3% of reoperation of cardiovascular surgeries in our department (45/617), while connective tissue disease took 42.2% (19/45) among the reoperation. There were 5 patients who died during perioperative period, including 2 cases due to cardiac arrest, 2 cases to persistent low cardiac output syndrome and 1 case to refractory hypoxemia. During the follow-up, 7 cases died, including 4 cases due to Behcet's disease, 1 case to Marfan's syndrome and 2 cases to aortic dissection. The outcomes of other cases were satisfactory. Kaplan-Meier survival analysis indicated the mortality rate of Behect's disease was the highest during follow-up period (Log rank test, P=0.0082). Conclusion Connective tissue disease is an important cause of aortic reoperation. Behcet's disease has the highest mortality and the worst prognosis.

Keywords

• cardiovascular surgery
• reoperation of aorta
• connective tissue disease
• behcet's disease