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[False aneurysm of the left ventricle and coronary aneurysms in Behçet disease]
J M Rolland1, O Bical, A Laradi
1Service de chirurgie cardiaque, hôpital Saint-Joseph, Paris.
Insights
This case report details a rare instance of cardiac involvement in Behçet's syndrome, presenting both ventricular and coronary artery aneurysms in a young patient. Surgical repair of the false ventricular aneurysm was successful, highlighting a unique combination of cardiovascular pathologies.
Area of Science:
- Cardiology
- Rheumatology
- Vascular Surgery
Background:
- Behçet's syndrome is a rare multisystemic inflammatory disease with a low incidence (6%) of cardiac involvement.
- Aneurysmal formation, particularly in the coronary and ventricular arteries, is an uncommon but serious manifestation of Behçet's syndrome.
- This case highlights the potential for complex cardiovascular pathology in patients with Behçet's syndrome.
Observation:
- A 29-year-old patient with Behçet's syndrome presented with a false left ventricular aneurysm and coronary artery aneurysms.
- The patient underwent surgical intervention involving cardiopulmonary bypass to close the false aneurysm using an endo-aneurysmal approach with a Gore-Tex patch.
- Coronary artery aneurysms were managed conservatively without intervention.
Findings:
- Successful surgical repair of a false left ventricular aneurysm in a patient with Behçet's syndrome.
- The patient experienced no postoperative complications following the procedure.
- The case demonstrates an unusual co-occurrence of ventricular and coronary artery aneurysms attributed to systemic angiitis and ischemic myocardial fragility.
Implications:
- This case underscores the importance of considering cardiac evaluation in Behçet's syndrome patients, even with rare presentations.
- The successful surgical management provides insight into treating complex aneurysmal disease in this patient population.
- Further research may elucidate the specific mechanisms linking Behçet's syndrome to combined ventricular and coronary aneurysms.
Abstract:
A false left ventricular aneurysm and coronary artery aneurysm were discovered in a 29 year old patient with Behçet's syndrome. The operation under cardiopulmonary bypass consisted of closing the neck of the false aneurysm by an endo-aneurysmal approach with a Gore-Tex patch. The coronary artery aneurysms were respected. There were no postoperative complications. Cardiac involvement is rare in Behçet's syndrome (6%). The originality of this case is the association of two aneurysmal pathologies: the coronary and ventricular aneurysms due to the angiitis and the myocardial fragility induced by ischaemia.