Predictors of paravalvular aortic regurgitation after surgery for Behcet’s disease-related severe aortic regurgitation
Abstract Background Behcet’s disease (BD)-related aortic regurgitation (AR) is known to be associated with paravalvular leakage (PVL) after successful aortic valve (AV) surgery. This study aimed to determine predictors of PVL after successful AV surgery in BD patients. We retrospectively collected d...
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doaj-ce85610015b04b2c9d70e27d151526792020-11-25T03:37:39ZengBMCOrphanet Journal of Rare Diseases1750-11722019-06-011411910.1186/s13023-019-1083-8Predictors of paravalvular aortic regurgitation after surgery for Behcet’s disease-related severe aortic regurgitationHong-Mi Choi0Hyung-Kwan Kim1Sung-Ji Park2Hyun-Jung Lee3Yeonyee E. Yoon4Jun-Bean Park5Yong-Jin Kim6Goo-Young Cho7In-Chang Hwang8Dae-Won Sohn9Jae K. Oh10Cardiovascular Center, Seoul National University Bundang Hospital, Seoul National University College of MedicineDivision of Cardiology, Cardiovascular Center, Department of Internal Medicine, Seoul National University College of MedicineDivision of Cardiology, Department of Medicine, Cardiovascular Imaging Center, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of MedicineDivision of Cardiology, Cardiovascular Center, Department of Internal Medicine, Seoul National University College of MedicineCardiovascular Center, Seoul National University Bundang Hospital, Seoul National University College of MedicineDivision of Cardiology, Cardiovascular Center, Department of Internal Medicine, Seoul National University College of MedicineDivision of Cardiology, Cardiovascular Center, Department of Internal Medicine, Seoul National University College of MedicineCardiovascular Center, Seoul National University Bundang Hospital, Seoul National University College of MedicineCardiovascular Center, Seoul National University Bundang Hospital, Seoul National University College of MedicineDivision of Cardiology, Cardiovascular Center, Department of Internal Medicine, Seoul National University College of MedicineDivision of Cardiology, Department of Medicine, Cardiovascular Imaging Center, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of MedicineAbstract Background Behcet’s disease (BD)-related aortic regurgitation (AR) is known to be associated with paravalvular leakage (PVL) after successful aortic valve (AV) surgery. This study aimed to determine predictors of PVL after successful AV surgery in BD patients. We retrospectively collected data of 35 patients (42.1 ± 9.1 years, 27 men) who underwent surgery for severe BD-related AR at two tertiary centers. The diagnosis was established based on echocardiographic, surgical, and/or pathological findings in conjunction with the International Study Group criteria for BD. A total of 76 cases of AV surgery in 35 patients were analyzed. Results A median follow-up duration was 8.0 years (interquartile range, 5.4–14.3 years). PVL developed in 18 patients (51.4%) within 2 years after the first surgery. Six patients who met the diagnostic criteria for BD did not develop PVL, in whom 5 patients took immunosuppressive therapy (IST). However, 4 of 9 patients (44.4%) who did not meet the diagnostic criteria developed PVL, in whom four (44.4%) patients took IST. On multivariable analysis, postoperative IST and concomitant aortic root replacement (ARR) were two independent predictors for less PVL development (HR 0.38, 95% CI 0.17–0.89, p = 0.025 for postoperative IST; HR 0.17, 95% CI 0.08–0.36, p < 0.001 for concomitant ARR). Preoperative IST use did not determine PVL development (p = 0.75). Conclusions Postoperative, but not preoperative, IST and concomitant ARR were independent predictors of less development of PVL. Special attention is required for early diagnosis BD-related AR, especially in patients not satisfying the current diagnostic criteria.http://link.springer.com/article/10.1186/s13023-019-1083-8Behcet’s diseaseAortic regurgitationParavalvular leakageAortic valve surgery |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Hong-Mi Choi Hyung-Kwan Kim Sung-Ji Park Hyun-Jung Lee Yeonyee E. Yoon Jun-Bean Park Yong-Jin Kim Goo-Young Cho In-Chang Hwang Dae-Won Sohn Jae K. Oh |
spellingShingle |
Hong-Mi Choi Hyung-Kwan Kim Sung-Ji Park Hyun-Jung Lee Yeonyee E. Yoon Jun-Bean Park Yong-Jin Kim Goo-Young Cho In-Chang Hwang Dae-Won Sohn Jae K. Oh Predictors of paravalvular aortic regurgitation after surgery for Behcet’s disease-related severe aortic regurgitation Orphanet Journal of Rare Diseases Behcet’s disease Aortic regurgitation Paravalvular leakage Aortic valve surgery |
author_facet |
Hong-Mi Choi Hyung-Kwan Kim Sung-Ji Park Hyun-Jung Lee Yeonyee E. Yoon Jun-Bean Park Yong-Jin Kim Goo-Young Cho In-Chang Hwang Dae-Won Sohn Jae K. Oh |
author_sort |
Hong-Mi Choi |
title |
Predictors of paravalvular aortic regurgitation after surgery for Behcet’s disease-related severe aortic regurgitation |
title_short |
Predictors of paravalvular aortic regurgitation after surgery for Behcet’s disease-related severe aortic regurgitation |
title_full |
Predictors of paravalvular aortic regurgitation after surgery for Behcet’s disease-related severe aortic regurgitation |
title_fullStr |
Predictors of paravalvular aortic regurgitation after surgery for Behcet’s disease-related severe aortic regurgitation |
title_full_unstemmed |
Predictors of paravalvular aortic regurgitation after surgery for Behcet’s disease-related severe aortic regurgitation |
title_sort |
predictors of paravalvular aortic regurgitation after surgery for behcet’s disease-related severe aortic regurgitation |
publisher |
BMC |
series |
Orphanet Journal of Rare Diseases |
issn |
1750-1172 |
publishDate |
2019-06-01 |
description |
Abstract Background Behcet’s disease (BD)-related aortic regurgitation (AR) is known to be associated with paravalvular leakage (PVL) after successful aortic valve (AV) surgery. This study aimed to determine predictors of PVL after successful AV surgery in BD patients. We retrospectively collected data of 35 patients (42.1 ± 9.1 years, 27 men) who underwent surgery for severe BD-related AR at two tertiary centers. The diagnosis was established based on echocardiographic, surgical, and/or pathological findings in conjunction with the International Study Group criteria for BD. A total of 76 cases of AV surgery in 35 patients were analyzed. Results A median follow-up duration was 8.0 years (interquartile range, 5.4–14.3 years). PVL developed in 18 patients (51.4%) within 2 years after the first surgery. Six patients who met the diagnostic criteria for BD did not develop PVL, in whom 5 patients took immunosuppressive therapy (IST). However, 4 of 9 patients (44.4%) who did not meet the diagnostic criteria developed PVL, in whom four (44.4%) patients took IST. On multivariable analysis, postoperative IST and concomitant aortic root replacement (ARR) were two independent predictors for less PVL development (HR 0.38, 95% CI 0.17–0.89, p = 0.025 for postoperative IST; HR 0.17, 95% CI 0.08–0.36, p < 0.001 for concomitant ARR). Preoperative IST use did not determine PVL development (p = 0.75). Conclusions Postoperative, but not preoperative, IST and concomitant ARR were independent predictors of less development of PVL. Special attention is required for early diagnosis BD-related AR, especially in patients not satisfying the current diagnostic criteria. |
topic |
Behcet’s disease Aortic regurgitation Paravalvular leakage Aortic valve surgery |
url |
http://link.springer.com/article/10.1186/s13023-019-1083-8 |
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