Rheumatoid aortic valve prolapse requiring emergency aortic valve replacement.

Abstract

Rapid progression of aortic regurgitation was closely observed in a patient with severe seropositive rheumatoid arthritis. Rheumatoid changes within the aortic valve leaflets resulted in severe prolapse necessitating emergency operation. The postoperative course was satisfactory.

Unusual Cause of a Stroke in a Patient with Seronegative Rheumatoid Arthritis

“…Histology shows the presence of either distinct granulomas identical to subcutaneous nodules or a non-specific inflammatory reaction [3]. The process is slow, yet rapidly progressive aortic valve disease followed by acute onset of valve incompetence has been reported in seropositive patients [4][5][6]. However, the patient described here was seronegative without evident signs of active arthritis.…”

“…This case suggests that the same indications as for vegetations should apply for granulomas regarding surgical intervention. The results are excellent, although there is no sufficient data on long-term prognosis [3,5]. Nevertheless, there is evidence that surgery may accelerate or trigger a relapse of the rheumatoid disease [3,8].…”

Aortic regurgitation in rheumatoid arthritis necessitating aortic valve replacement

“…Histopathologically there are two varieties of valvular lesions; the more common granulomatous involvement of the valve leaflets and ring and the rarer non-granulomatous inflammation of the valve with thickening and fibrosis of the leaflets [2,3]. Pathophysiologically aortic incompetence can be considered to be caused by a number of different mechanisms [4]; aortitis with dilatation of the aortic ring, a destructive process of the valve leaflets themselves or finally prolapse of actively inflamed degenerate cusps.…”