Off-pump coronary artery bypass grafting in a patient with Behçet's disease

Area of Science:

• Cardiology
• Vascular Surgery
• Rheumatology

Background:

• Behçet's disease is a rare systemic vasculitis that can affect major blood vessels, including coronary arteries.
• Severe triple-vessel coronary artery disease necessitates surgical intervention, such as coronary artery bypass grafting (CABG).

Observation:

• A 58-year-old male with known Behçet's disease presented with chest pain due to severe triple-vessel coronary artery disease.
• Urgent coronary artery bypass grafting was indicated.

Findings:

• Off-pump coronary artery bypass grafting using the aortic no-touch technique was performed to mitigate risks associated with Behçet's disease, such as anastomotic leakage and pseudoaneurysm formation.
• Postoperative angiography confirmed all grafts were patent, and no anastomotic pseudoaneurysms were detected.
• Pathological analysis of the internal thoracic artery revealed vascular changes consistent with Behçet's disease.

Implications:

• The aortic no-touch technique may be a safer approach for CABG in patients with Behçet's disease.
• Long-term surveillance for pseudoaneurysm formation is crucial in these patients post-CABG.
• Understanding the vascular manifestations of Behçet's disease is vital for surgical planning and patient management.