Assessment of disease activity control and evaluation strategy in patients with Takayasu arteritis undergoing cardiac surgery: a retrospective cohort study.

Introduction: For patients with Takayasu's arteritis (TAK) requiring cardiac surgery, optimizing preoperative disease activity control and assessment is pivotal to improving surgical outcomes; however, an established strategy to minimize activity-driven adverse events remains undefined. Following the 2014 implementation of an institutional, multidisciplinary TAK activity control and evaluation strategy, this study aimed to robustly assess its clinical safety. Methods: This single-center retrospective cohort study included 64 patients with TAK and cardiac involvement who underwent cardiopulmonary bypass surgery under this multidisciplinary protocol. Propensity score-matched non-TAK (NTAK) patients undergoing identical surgeries during the same period served as controls. Outcomes were short-term mortality/complications and mid-term survival/complications across a mean follow-up period of 4.1 years. Results: The TAK cohort demonstrated a higher incidence of surgical site complications than controls (17.19% vs. 0%, Discussion: Guided by a systematic, multidisciplinary disease activity control and evaluation strategy, cardiac surgery via cardiopulmonary bypass for patients with TAK was not associated with increased mortality or major perioperative complications compared to matched NTAK controls. Although patients with TAK face elevated long-term risks of recurrent cardiovascular events and future interventions, the risk of initial surgical failure was not augmented relative to matched NTAK controls.