Sugimoto T, Miyashita M, Ota T, Yamashita C, Okada M, Nakamura K
Department of Surgery, Kobe University School of Medicine, Japan.
Nihon Kyobu Geka Gakkai Zasshi. 1990 Nov;38(11):2320-5.
We experienced two patients of valvular heart disease associated with Behçet's disease. First patient presented aortic regurgitation (AR) due to perforation of left coronary cusp of the aortic valve and underwent valve replacement (AVR). Second patient showed AR due to shortening of the aortic valve along with mitral regurgitation caused by dilatation of the annulus, and received AVR as well as mitral annuloplasty by Kay's method. Each patient has been doing well for 5 and 2 years after operation, respectively. Patients with Behçet's disease often have perivalvular leakage after valve replacement. We treated our patients as follows to prevent this serious postoperative complication. 1. The operation was performed when the inflammatory signs and findings subsided with enough adrenal steroids. 2. At operation, the prosthetic valve of one size smaller than the size considered suitable was selected for valve replacement. 3. The adrenal steroids have been continuously administrated and adjusted according to the values of CRP and ESR as well as the cutaneous and mucous manifestations of this disease.
我们遇到了两名患有与白塞病相关的心脏瓣膜病患者。首例患者因主动脉瓣左冠状动脉瓣叶穿孔出现主动脉反流（AR），并接受了瓣膜置换术（AVR）。第二例患者因主动脉瓣缩短以及瓣环扩张导致二尖瓣反流而出现AR，并接受了AVR以及采用Kay法进行的二尖瓣瓣环成形术。两名患者术后分别已良好生存5年和2年。白塞病患者在瓣膜置换术后常出现瓣周漏。我们对患者采取了以下措施以预防这种严重的术后并发症。1. 在炎症体征和表现经足够的肾上腺皮质激素治疗消退后进行手术。2. 手术时，选择比认为合适尺寸小一号的人工瓣膜进行瓣膜置换。3. 持续给予肾上腺皮质激素，并根据CRP和ESR值以及该疾病的皮肤和黏膜表现进行调整。
