診断に苦慮し4回の大動脈弁置換術を要したBehçet病による再発性大動脈弁輪破壊の1例

Four Times Aortic Valve Replacement for Recurrent Aortic Annulus Destruction Due to Behçet’s Disease：Report of a Case

はじめに　Behçet病は急性炎症性発作を反復しつつ慢性に経過する原因不明の炎症性疾患であり，まれに心血管系の障害を合併する．Behçet病による心内膜炎を伴う大動脈弁閉鎖不全症に対して手術療法を要することがあり，弁置換術後の人工弁縫合不全や仮性瘤形成など，重篤な合併症をきたしうるとされている1～3）．われわれは，診断に苦慮し計4回の大動脈弁置換術を要したBehçet病による再発性大動脈弁輪破壊の1例を経験したので報告する．

Surgical results of aortic regurgitation with Behcet’s aortitis is associated with high morbidity and mortality due to risk of annular dehiscence.

Here we describe a case of severe aortic regurgitation with Behcet’s disease in 51-year-old man who underwent aortic valve replacement and subannular patch reconstruction for suspected infectious endocarditis with severe aortic regurgitation and subannular abcess. Then we performed three times aortic valve replacement for recurrent prosthetic valve dehiscence. Before the fourth operation, the patient was diagnosed with Behcet’s disease and given immunosuppressant. Postoperative course was uneventful and he was discharged on postoperative day 59th, and doing well.