PMID- 28810271
OWN - NLM
STAT- MEDLINE
DCOM- 20181009
LR  - 20181009
IS  - 1439-1902 (Electronic)
IS  - 0171-6425 (Linking)
VI  - 66
IP  - 2
DP  - 2018 Mar
TI  - Outcomes of Patients with Behcet's Syndrome after Pulmonary Endarterectomy.
PG  - 187-192
LID - 10.1055/s-0037-1604411 [doi]
AB  - BACKGROUND: Behcet's syndrome (BS) is a multisystem disorder and is not known as 
      a risk factor for chronic thromboembolic pulmonary hypertension (CTEPH), for 
      which the treatment of choice is pulmonary endarterectomy (PEA). The aim of this 
      study was to review our experience in the surgical treatment of CTEPH in patients 
      with BS. METHODS: Data were collected prospectively for consecutive patients with 
      BS who underwent PEA over a 6-year period. RESULTS: We identified nine patients 
      (seven males, two females, mean age: 34.7 +/- 9.9 years) with BS. The mean disease 
      duration before PEA was 88.0 +/- 70.2 months. All patients but one received 
      immunosuppressive therapy before the surgery. Exercise-induced dyspnea presented 
      symptoms in six patients. One patient had associated intracardiac thrombosis. PEA 
      was bilateral in five patients, unilateral in three, and lobar in one. No 
      perioperative mortality was observed; however, one patient died four weeks after 
      PEA due to massive hemoptysis. Morbidity was observed in two patients. The 
      systolic pulmonary artery pressure fell significantly from 59.0 +/- 22.7 mm Hg to 
      30.0 +/- 6.5 mm Hg after surgery (p = 0.031). Pulmonary vascular resistance also 
      improved significantly from 611.8 +/- 300.2 to 234.7 +/- 94.9 dyn/s/cm(5) 
      (p = 0.031). After a median follow-up of 29.4 months, all patients improved to 
      the New York Heart Association (NYHA) functional class I and II. CONCLUSION: 
      Patients with BS may suffer recurrent pulmonary embolism and develop CTEPH. In 
      patients who do not respond to anticoagulation or immunosuppressive therapy, PEA 
      may be a therapeutic option when thrombotic lesions are surgically accessible. 
      Due to the high risk of perioperative mortality, the procedure should be 
      undertaken in centers with experience.
CI  - Georg Thieme Verlag KG Stuttgart . New York.
FAU - Yildizeli, Sehnaz Olgun
AU  - Yildizeli SO
AD  - Department of Pulmonology and Intensive Care, Marmara University School of 
      Medicine, Istanbul, Turkey.
FAU - Yanartas, Mehmed
AU  - Yanartas M
AD  - Department of Cardiovascular Surgery, Kartal Kosuyolu Hospital, Istanbul, Turkey.
FAU - Tas, Serpil
AU  - Tas S
AD  - Department of Cardiovascular Surgery, Kartal Kosuyolu Hospital, Istanbul, Turkey.
FAU - Direskeneli, Haner
AU  - Direskeneli H
AD  - Department of Rheumatology, Marmara University School of Medicine, Istanbul, 
      Turkey.
FAU - Mutlu, Bulent
AU  - Mutlu B
AD  - Department of Cardiology, Marmara University School of Medicine, Istanbul, 
      Turkey.
FAU - Ceyhan, Berrin
AU  - Ceyhan B
AD  - Department of Pulmonology and Intensive Care, Marmara University School of 
      Medicine, Istanbul, Turkey.
FAU - Yildizeli, Bedrettin
AU  - Yildizeli B
AD  - Department of Thoracic Surgery, Marmara University School of Medicine, Istanbul, 
      Turkey.
LA  - eng
PT  - Journal Article
DEP - 20170815
PL  - Germany
TA  - Thorac Cardiovasc Surg
JT  - The Thoracic and cardiovascular surgeon
JID - 7903387
RN  - 0 (Anticoagulants)
RN  - 0 (Immunosuppressive Agents)
SB  - IM
MH  - Adult
MH  - Anticoagulants/therapeutic use
MH  - Arterial Pressure
MH  - Behcet Syndrome/*complications/diagnosis/drug therapy
MH  - Chronic Disease
MH  - Computed Tomography Angiography
MH  - *Endarterectomy/adverse effects
MH  - Female
MH  - Humans
MH  - Hypertension, Pulmonary/diagnostic imaging/etiology/physiopathology/*surgery
MH  - Immunosuppressive Agents/therapeutic use
MH  - Male
MH  - Middle Aged
MH  - Prospective Studies
MH  - Pulmonary Artery/diagnostic imaging/physiopathology/*surgery
MH  - Pulmonary Embolism/diagnostic imaging/etiology/physiopathology/*surgery
MH  - Recovery of Function
MH  - Risk Factors
MH  - Time Factors
MH  - Treatment Outcome
MH  - Vascular Resistance
MH  - Young Adult
COIS- Disclosure The authors report no conflicts of interest in this work.
EDAT- 2017/08/16 06:00
MHDA- 2018/10/10 06:00
CRDT- 2017/08/16 06:00
PHST- 2017/08/16 06:00 [pubmed]
PHST- 2018/10/10 06:00 [medline]
PHST- 2017/08/16 06:00 [entrez]
AID - 10.1055/s-0037-1604411 [doi]
PST - ppublish
SO  - Thorac Cardiovasc Surg. 2018 Mar;66(2):187-192. doi: 10.1055/s-0037-1604411. Epub 
      2017 Aug 15.