Surgical management of cardiovascular lesions caused by systemic inflammatory diseases

The surgical treatment of cardiovascular disorders caused by inflammatory diseases presents many difficulties, including suture detachment and progression of vascular lesions. We here report the various surgical procedures used to treat these disorders and their long-term outcomes.

We operated on 14 patients: eight with Takayasu's disease, three with systemic lupus erythematosus, two with rheumatoid arthritis, and one with Behçet's disease. Patients were divided into three groups as follows; patients (n=7) requiring aortic valve replacement; patients (n = 4) requiring reconstruction of the coronary artery; and patients (n = 3) requiring aortic aneurysm repair.

There were no early or late deaths in the postoperative follow-up period of 70 +/- 40 months, but there was one operative death. Three patients received postoperative steroids due to progression of the inflammation. However, there were no major complications such as valve detachment, pseudoaneurysmal formation, or occlusion of the bypass conduit.

We conclude that it is crucial to reduce inflammation pre- and postoperatively, to reinforce the suture line, and to carefully select the operative procedures when treating cardiovascular disorders caused by inflammatory diseases.