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Cardiothoracic interventions in Behçet's disease
1The First Hospital of Putian, Teaching Hospital, Fujian Medical University, Putian, China. shi_min_yuan@yahoo.com.
Insights
Cardiothoracic interventions for Behçet's disease cardiovascular complications are detailed, with cardiac surgery being most common. High rates of postoperative complications and recurrence were observed, particularly prosthetic valve dehiscence.
Area of Science:
- Cardiology
- Thoracic Surgery
- Vascular Surgery
Background:
- Behçet's disease is a rare multisystemic inflammatory disorder.
- Cardiovascular complications are a significant cause of morbidity and mortality in Behçet's disease.
- Limited data exists on cardiothoracic interventions for these complications.
Purpose of the Study:
- To elucidate the role and outcomes of cardiothoracic interventions for cardiovascular complications of Behçet's disease.
- To analyze the types of procedures, indications, and complication rates.
- To identify factors influencing outcomes.
Main Methods:
- A comprehensive literature search was conducted for studies published between 2000 and 2013.
- Articles focusing on cardiothoracic procedures for cardiovascular complications of Behçet's disease were screened and analyzed.
- Data on procedure types, indications, postoperative outcomes, and recurrence were extracted.
Main Results:
- A total of 221 major cardiothoracic procedures were analyzed, with cardiac operations (79.6%) being most frequent.
- Common indications included aortic valve regurgitation, pulmonary artery aneurysm, and thrombosis.
- High postoperative morbidity (21.4%), recurrence (11.7%), and mortality (15.0%) rates were reported.
- Prosthetic valve dehiscence was the leading cause of morbidity and mortality.
Conclusions:
- Cardiovascular operations are prevalent for Behçet's disease complications, often involving valve, aneurysm, or thrombotic issues.
- Postoperative complications and recurrence rates are substantial.
- Intensified immunosuppressive therapy may mitigate postoperative complications and reintervention needs.
Objectives:
Cardiothoracic interventions for cardiovascular complications of Behçet's disease have not been sufficiently elucidated.
Methods:
A comprehensive literature search of cardiovascular complications of Behçet's disease was made for year range 2000-2013. The articles on the cardiothoracic procedures for cardiovascular complications of Behçet's disease were screened and analysed.
Results:
The 221 major cardiothoracic procedures performed in this patient setting included 176 (79.6%) cardiac, 9 (4.1%) thoracic, 31 (14.0%) interventional and 5 (2.3%) hybrid procedures (χ2=478.03, p<0.0001). Of the major cardiac operations, there were 74 (42%) valvular, 58 (33%) aneurysmal, 23 (13.1%) thrombotic, 10 (5.7%) coronary and 11 (6.3%) miscellaneous procedures. The postoperative morbidity, recurrence and mortality rates were 21.4%, 11.7% and 15.0%, and the reintervention rates were 15.4% for recurrence, and 43.2% for morbidity patients. Dehiscence of the prosthetic valve was the major morbidity (52.3%) and the major cause of death (63.6%). The cardiac surgical patients carried the highest mortality rate comparing with thoracic, interventional and hybrid treatment patients.
Conclusions:
Cardiovascular operations prevailed thoracic and interventional procedures for the cardiovascular complications of Behçet's disease. Postoperative complications and recurrence rates were high. Aortic valve regurgitation, pulmonary artery aneurysm, and intracardiac and great vessel thrombosis were the most common indications for a cardiothoracic intervention. Dehiscence of the prosthetic valve was the main cause of death of the cardiothoracic interventions. Intense immunosuppressive treatment may reduce the postoperative complications and the need for reinterventions.
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