The surgical outcomes of aortic valve replacement in patients with aortic valve lesions caused by Behcet’s disease: lessons we learned

Editorial: Reviews in heart valve stenosis and regurgitation

“…Patients with severe regurgitation often present with perivalvular leakage, pseudoaneurysm, and a poor long-term prognosis. Tang et al aimed to summarize the evolution of surgical techniques for Behçet's disease and its symptoms leading to aortic regurgitation ( 8 , 9 ). The authors pointed out that patients with severe complications and end-stage heart failure may benefit from TAVR.…”

Surgical treatment of Behcet's disease with severe aortic regurgitation

“…Aortic valve replacement (AVR) and aortic root replacement (ARR) are standard techniques for severe AR ( 21 , 37 ), but postoperative complications in patients with BD, such as perivalvular leakage and pseudoaneurysm, remain high, and the long-term prognosis is poor ( 15 , 18 , 34 , 38 ). In recent years, with a better understanding of BD pathophysiology, clinical centers have proposed modified surgical strategies ( Table 3 ) and drug treatment regimens ( Table 4 ) in anticipation of improving the prognosis of BD.…”

“…Sun et al ( 18 ) performed modified AVR with reinforcement of the aortic root on five BD patients with AR. Beneath the ostia of both coronary arteries, they used interrupted mattress stitches from the outside in and horizontally through the aortic wall in the same plane below the valve ring in a circumferential fashion.…”

“…The probability of valve detachment or paravalvular leakage after AVR in patients with BD is 40%–86.7% ( 18 , 19 , 32 , 34 ). In the report of Jeong et al ( 32 ), 78.9% of patients needed a reoperation, and 36.8% of patients needed two or more reoperations.…”

“…However, it is difficult for fragile tissue to support high suture tension because BD-induced inflammation affects the aortic valve and aortic root tissues. Postoperative complications, such as paravalvular leaks (PVL) and valve dehiscence/detachment, can easily occur and require two or more cardiac surgeries, and the incidence is 40%–86.7% ( 18 , 19 ). It is a hot topic to find the best surgical treatment strategy and drug intervention for BD with AR.…”