Cardiothoracic interventions in Behçet's disease.

OBJECTIVES: Cardiothoracic interventions for cardiovascular complications of Behcet's disease have not been sufficiently elucidated. METHODS: A comprehensive literature search of cardiovascular complications of Behcet's disease was made for year range 2000-2013. The articles on the cardiothoracic procedures for cardiovascular complications of Behcet'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 Behcet'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.