Abstract
Objective:
In our clinic, we aimed to investigate the effect of preoperative
risk factors and
postoperative complications on
reoperation and
mortality in cases with
Behçet's disease which presents very rare
coronary artery involvement.
Methods:
Thirteen
patients with
Behçet's Disease who had undergone
coronary artery bypass grafting in our center between 2003 and 2015 were analyzed. We evaluated the clinical and
laboratory findings,
complications and
mortality rates of our
patients in
light of the
literature.
Results:
The mean age was 38.5 (30-55; 3
women). The mean
time from onset of
Behçet's disease to
coronary artery disease was 4,7 (3-11) years. Fifty-four percent of the
patients were asymptomatic.
Coronary artery disease of these was exposed while peripheral
vascular surgery was planned due to
complications of
Behçet's disease. Symptomatic
patients presented
angina pectoris (31%),
acute coronary syndrome (8%) and
arrhythmia (8%). In coronary
pathology of
patients, distal type obstruction (31%),
aneurysm and
pseudoaneurysm (31%), proximal segment
thrombus (15%), chronic type
stenosis and occlusions (31%) were present. Early
mortality (15%) was due to acute
myocardial infarction while the late
mortality (15%) was due to cerebral and gastrointestinal
bleeding.
Reoperation was due to
bleeding in one case on the 1st postoperative day and due to acute
pulmonary embolism in another case in the 3rdpostoperative year.
Conclusion:
In
Behçet's disease,
coronary artery bypass grafting is a
procedure with high
mortality, especially in the acute period. The on-pump
surgery technique in these cases can be safely performed for multiple bypasses and in
patients above 40 years old.