Background
Thoracic aortitis is identified on post-operative histopathology of 2-12% of aortic aneurysms following aortic repair or replacement surgery. Clinically isolated aortitis (CIA) is condition which consists of non-infectious inflammation topographically limited to the thoracic aorta without any other signs or symptoms suggestive of a systemic inflammatory disease. As such CIA, in particular of the conditions leading to thoracic aortitis, is usually only diagnosed incidentally post-operatively.
There is little evidence regarding long term outcomes for patients with thoracic aortitis or CIA. No previous studies have examined comparisons of immediate post-surgical outcomes with controls. As such, clinicians base decisions about post-operative immunosuppressive treatment of these patients largely upon individual experience and clinical judgment.
There is a clear need to gather more information about the nature of thoracic aortitis, CIA and their outcomes in order to help direct therapeutic decisions in patients who have had an incidental finding of thoracic aortitis.
Aim
The primary aim was to compare the 30-day post-operative mortality, morbidity and resource utilisation of patients with thoracic aortitis with a control group following thoracic aortic repair or replacement surgery. The secondary aim was to compare the outcomes of aortitis patients who had received immunotherapy with those who had not. This was intended to help inform clinicians in their decision-making regarding whether to commence immunosuppressive treatment in aortitis patients in the postoperative period.
Method
The study was performed at three Sydney tertiary hospitals. Surgical patients with thoracic aortitis were identified from histopathology records over the period of January 2004 to December 2018. They were then classified as either clinically isolated aortitis, giant cell arteritis, Takayasu’s arteritis or other aortitis based upon analysis of inpatient notes and investigations. These patient were then also secondarily stratified into whether they had received immunotherapy post-operatively or not. Post-operative mortality, morbidity and resource utilisation data was collected from surgical databases for all patients who underwent thoracic aortic repair or replacement surgery. 30-day mortality and morbidity and re-operation rates of the aortitis group were compared with matched controls from the non-aortitis group.
Results and conclusion
This study is still currently underway and full results and conclusions will be presented at the meeting.