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Coronary revascularization and abdominal aortic aneurysm repair in a patient with Behçet's diseases
H Hirose1, M Takagi, M Noguchi
1Department of Cardiovascular Surgery, Nagasaki University Hospital, Nagasaki City, Japan. genex@idt.net
Insights
This study reports the first successful combined surgical repair of coronary artery and abdominal aortic lesions in a patient with Behçet's disease, a rare systemic vasculitis.
Area of Science:
- Cardiovascular Medicine
- Rheumatology
- Vascular Surgery
Background:
- Behçet's disease is a systemic inflammatory disorder.
- Arterial complications, though uncommon, can affect major vessels like the aorta.
- Coronary artery involvement in Behçet's disease is rarely documented.
Observation:
- A case of Behçet's disease presented with both coronary artery stenosis and a supra-renal abdominal aortic aneurysm.
- The patient underwent successful revascularization of coronary lesions.
- Simultaneously, abdominal aortic repair was performed with precautions against coronary ischemia.
Findings:
- Successful surgical management of combined coronary and abdominal aortic disease in Behçet's disease is presented.
- This case highlights the feasibility of complex vascular reconstruction in this patient population.
- The surgical approach mitigated risks associated with aortic clamping and potential coronary ischemia.
Implications:
- This successful intervention expands treatment options for patients with Behçet's disease and complex vascular manifestations.
- It underscores the importance of considering and managing arterial complications in Behçet's disease.
- Further research into the cardiovascular impact of Behçet's disease is warranted.
Abstract:
Behçet's disease is a systemic disease characterized by oral aphta, genital ulcer, and ocular lesion. Arterial involvement is an uncommon complication of Behçet's disease, and it most frequently affects the abdominal aorta followed by the femoral artery and the pulmonary artery. Coronary lesions in Behçet's disease have been little reported in the literature. In this communication, we present a case with coronary artery stenosis and with subsequently developed supra-renal abdominal aortic aneurysm. The coronary lesions were revasculized with gastroepiploic artery, right internal mammary artery, and saphenous vein graft. Abdominal aortic repair was performed with partial cardiopulmonary stand by, because of the risk of coronary ischemia during the cross clamp including the celiac artery. To our knowledge, this is the first report of successful repair of combined lesions of the coronary and the abdominal aorta in a patient with Behçet's disease.