Surgical management of cardiovascular lesions caused by systemic inflammatory diseases

Background: The surgical treatment of cardiovascular disorders caused by in flammatory diseases presents many difficulties, including suture detachment and progression of vascular lesions. We here report the various surgical p rocedures used to treat these disorders and their long-term outcomes. Metho ds: We operated on 14 patients: eight with Takayasu's disease, three with s ystemic lupus erythematosus, two with rheumatoid arthritis, and one with Be hcet's disease. Patients were divided into three groups as follows; patient s (n=7) requiring aortic valve replacement; patients (n=4) requiring recons truction of the coronary artery; and patients (n=3) requiring aortic aneury sm repair. Results: There were no early or late deaths in the postoperative follow-up period of 70 +/- 40 months, but there was one operative death. T hree patients received postoperative steroids due to progression of the inf lammation. However, there were no major complications such as valve detachm ent, pseudoaneurysmal Formation, or occlusion of the bypass conduit. Conclu sions: We conclude that it: is crucial to reduce inflammation pre- and post operatively, to reinforce the suture line, and to carefully select the oper ative procedures when treating cardiovascular disorders caused by inflammat ory diseases.