Rare Case of Multiple Giant Coronary Aneurysms in Behcet Disease: Surgical Treatment

Coronary artery aneurysms in patients with Behcet’s disease are rare (< 0,5%). Giant aneurysms defined as greater than 2 cm are exceptional. We are reporting a rare case of a 56 year old man with Behcet’s disease, admitted for chest pain and AV block, whose angiogram revealed a pair of giant aneurysms (greater than 2 cm) involving the left anterior descending artery and proximal circumflex artery with severe stenosis of both vessels. We revised the literature to find the best option of treatment for those patients and it was no clear, so we decided to operate the patient for coronary artery revascularization with both internal thoracic arteries and ligate the aneurisms if possible.

We perform two coronary by pass with both internal thoracic arteries and ligate the aneurysm of the descendent anterior proximal and also the distal part of the circumflex aneurysm.

The postoperative course was uneventful, and echo- cardiography showed normal ejection fraction (0.55). The patient was discharged 8 days postoperatively after resumption of full treatment for his disease. The patient was asymptomatic at the latest follow-up. Control angiogram showed an excellent patency of the bypass along with both aneurysms occluded