Surgical treatment of Behcet's disease involving aortic regurgitation

Background. Behcets disease involving aortic regurgitation is rare, and pro sthetic valve detachment after aortic valve replacement is one of the most serious complications reported. We investigated the surgical results in 10 patients with aortic regurgitation caused by Behcet's disease. Methods. between 1981 and 1997, 10 patients with aortic regurgitation secon dary to Behcet's disease had surgery. There were 8 men and 2 women, and the ir ages ranged from 33 to 60 years (mean, 46 +/- 8 years). The surgical pro cedures for aortic regurgitation were aortic valve replacement in 6 patient s and Bentall type operation in 4. Results. No patient died during the hospital stay. The follow-up periods ra nged from 11 to 185 months (mean, 87 months). Two patients died during the follow-up period. The acturial survival rate was 89% at 5 years and 67% at 10 years. Prosthetic valve detachment or suture detachment requiring redo o peration occurred in 4 patients, 3 of whom had redo operations twice. Four patients had a composite graft replacement, and 1 patient died after the op eration. No prosthetic valve detachment was noted in 64% of the patients at 5 years and in 43% at 10 years. Conclusions. The rate of prosthetic valve detachment was 40% (4 of 10 patie nts), with a higher incidence in patients with Behcet's disease than in tho se treated during the same period at the same hospital for aortitis caused by other diseases. Surgical techniques for treatment of this condition shou ld be modified to improve the surgical outcome in these patients. (C) 1999 by The Society of Thoracic Surgeons.