Aortic valve replacement in Behcet's disease: surgical modification to prevent valve detachment

Area of Science:

• Cardiology
• Cardiac Surgery
• Vascular Surgery

Background:

• Aortic regurgitation secondary to Behcet's disease presents unique challenges for aortic valve replacement (AVR).
• Prosthetic valve detachment is a significant complication following AVR in these patients.
• Previous AVR surgeries at our institute experienced detachment in five consecutive cases between 1981 and 2006.

Purpose of the Study:

• To introduce and evaluate a novel surgical technique, the 'subannular ring reinforcement technique,' designed to prevent prosthetic valve detachment during AVR for Behcet's disease.
• To assess the efficacy and safety of this modified AVR procedure in patients with aortic regurgitation due to Behcet's disease.

Main Methods:

• A modified AVR procedure involving a 'subannular ring reinforcement technique' was developed.
• This technique involves placing a ring-shaped prosthetic graft in the subannular position.
• The aortic valve annulus is secured between the prosthetic valve and the graft using vertical mattress sutures.

Main Results:

• The modified AVR technique was performed on three patients.
• No instances of prosthetic valve detachment were observed in these patients.
• Follow-up data showed no detachment after a mean period of 3+/-1.8 years (range: 1.5-5.1 years).

Conclusions:

• The subannular ring reinforcement technique appears to be effective in preventing prosthetic valve detachment in AVR for Behcet's disease.
• The technique may enhance prosthesis fixation by distributing stress to the annulus and rigidly securing the prosthesis.
• This novel approach offers a promising solution for managing complex aortic regurgitation in Behcet's disease patients.