Valve repair for mitral insufficiency secondary to idiopathic juvenile polyarthritis.
A female patient in whom idiopathic rheumatoid polyarthritis was diagnosed at the age of 8 years required surgery for severe mitral valve insufficiency 16 years later. Intraoperative analysis revealed a fibrotic endocarditis involving mainly the posterior leaflet. Granulomatous vegetations as well as a large thrombus which filled the left ventricular apex and simulated endomyocardial fibrosis were noted. Valve repair was achieved using an anterior leaflet augmentation with a patch of mitral homograft associated with a prosthetic ring annuloplasty. Postoperatively, a severe pericardial effusion required surgical drainage. Eight years later, the patient had no cardiac symptoms and echocardiography confirmed a normally functioning mitral valve.
Aubert
Stéphane
S
Cardiovascular Surgery, Institute of Cardiology, Hôpital Pitié Salpétrière, Paris, France.
Hayem
Gilles
G
Aumont
Marie-Claude
MC
Brochet
Eric
E
Acar
Christophe
C
D000328:Adult; D001171:Arthritis, Juvenile / Q000150:complications*; D004696:Endocarditis / Q000601:surgery; D005260:Female; D005355:Fibrosis / Q000601:surgery; D006099:Granuloma / Q000601:surgery; D006801:Humans; D008943:Mitral Valve / Q000601:surgery*; D008944:Mitral Valve Insufficiency / Q000209:etiology* / Q000601:surgery*; D013927:Thrombosis / Q000601:surgery