白塞病累及主动脉根部的改良Bentall手术治疗：一例报告
Behcet's disease involved the root of aorta in the treatment with modified Bentall procedure: a case report.
作者信息
Cheng Zeyi, Kang Zhefeng, Ji Yupeng, Guo Yingqiang
机构信息
Department of Cardiovascular Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, People's Republic of China.
出版信息
J Cardiothorac Surg. 2020 Jan 29;15(1):30. doi: 10.1186/s13019-020-1070-0.
BACKGROUND
Behcet's disease (BD) is a multisystemic vasculitis of unknown etiology, the incidence of cardiovascular system involvement is rare, about1-5% (Sakane et al., N Engl J Med 341:1284-91, 1999). BD combined with aortic pseudoaneurysm and aortic valve regurgitation is usually need surgical treatment, but there is controversy about which surgical method to choose.
CASE PRESENTATION
We report a case of BD combined with severe aortic valve regurgitation and two giant pseudoaneurysms of the aortic sinus. The patient underwent modified Bentall procedure (MBP) and use oral immunosuppressive as well as corticosteroid strictly, after 8 months follow-up, the patient recovered well.
CONCLUSION
For patient with aortic valve regurgitation and ascend aortic pseudoaneurysm caused by BD, we recommend modified Bentall procedure when rheumatism in a stable period. Corticosteroids and immunosuppressive drugs should be used before and after surgery.
背景
白塞病（BD）是一种病因不明的多系统血管炎，心血管系统受累的发生率较低，约为1%-5%（Sakane等人，《新英格兰医学杂志》341:1284-91，1999年）。BD合并主动脉假性动脉瘤和主动脉瓣反流通常需要手术治疗，但对于选择哪种手术方法存在争议。
病例报告
我们报告一例BD合并严重主动脉瓣反流和两个主动脉窦巨大假性动脉瘤的病例。患者接受了改良Bentall手术（MBP），并严格使用口服免疫抑制剂和皮质类固醇，随访8个月后，患者恢复良好。
结论
对于BD引起的主动脉瓣反流和升主动脉假性动脉瘤患者，我们建议在风湿处于稳定期时采用改良Bentall手术。手术前后应使用皮质类固醇和免疫抑制药物。
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