Rheumatoid involvement of the aortic arch.
The clinical course of rheumatoid arthritis may be complicated by cardiac involvement. Indeed, postmortem studies suggest rheumatoid involvement in up to 50% of pericardial, 5% of myocardial, and 60% of valvular specimens. Yet, in our search of the literature, we found only a single case report describing aortic valve replacement for rheumatoid valvulitis. This discrepancy may be related to the paucity of symptoms in this sedentary group of patients. A complete cardiac evaluation of patients with rheumatoid arthritis is recommended to select those with significant valvular involvement for timely surgical intervention prior to the development of irreversible left ventricular dysfunction. Two patients who benefitted from aortic valve replacement for rheumatoid valvular disease are presented.
Wetstein
Lewis
L
Departments of Cardiothoracic Surgery and Pathology, State University of New York, Downstate Medical Center, 450 Clarkson Avenue, Brooklyn, New York 11203.
Ergin
M Arisan
MA
Harken
Alden H.
AH
Eftekhari
Mohammad
M
Griepp
Randall B.
RB