Clinical and Pathological Spectrum of Aortitis in a Chinese Cohort.

BACKGROUND: This study aimed to explore the clinical and pathological features of aortitis in China, which is a rare disease that is often overlooked preoperatively.

METHODS: We reviewed the records of 2950 patients who underwent aortic surgery at Wuhan Asia General Hospital from 2016 to 2023. Clinical and pathological data were collected and compared across different groups.

RESULTS: Out of 2950 patients, 15 had healed aortitis, 2 which were healed Takayasu Aortitis (TAK) and 13 that were not further classified. 42 had active aortitis, including clinically isolated aortitis (CIA, 42.9%), infectious aortitis (IA, 26.2%), Takayasu arteritis (TAK, 16.7%), and Behçet's syndrome (BS, 14.3%), half of these cases were not recognized preoperatively. All patients who developed perivalvular leakage during follow-up had concurrent non-infectious valvulitis with mixed inflammatory pattern at the time of initial surgery. 17 out of 18 patients with CIA survived without complications, as did 8 out of 11 patients with IA, 6 out of 7 patients with TAK, and 2 out of 6 patients with BS.

CONCLUSIONS: Half of the aortitis cases were initially diagnosed by pathologists. Non-infectious valvulitis with mixed inflammatory pattern is a risk factor for perivalvular leakage. BS is associated with a higher rate of complications. Patients with CIA have a good prognosis in China, which is different from the West.