Early prosthetic valve failure in a patient with rheumatoid arthritis.
Heart lesions in patients with rheumatoid arthritis (RA) are well documented in literature; however, in the majority of cases these are incidental findings at postmortem. Most patients do not require cardiac surgical intervention unless they develop complications such as significant valvular regurgitation. Patients with RA often require orthopedic operations and therefore a bioprosthetic valve replacement is normally advocated to avoid problems related to anticoagulation. We report a case of a 64-year-old woman with seropositive RA who had undergone bioprosthetic aortic valve replacement three years previously. She re-presented with early prosthetic valve failure due to accelerated degeneration and calcification. This was treated successfully with redo replacement with a mechanical prosthesis. Here, we discuss our experience and debate the various valve choices available that should be considered in patients with rheumatoid disease.
Asopa
Sanjay
S
Wessex Cardiothoracic Unit, Southampton General Hospital, Tremona Road, Southampton, Hampshire, UK. asopa2000@yahoo.com
Iyengar
Srikanth
S
Velissaris
Theodore
T
Ohri
Sunil K
SK
D001021:Aortic Valve; D001172:Arthritis, Rheumatoid / Q000150:complications*; D005260:Female; D005500:Follow-Up Studies; D006349:Heart Valve Diseases / Q000150:complications / Q000601:surgery*; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000379:methods; D006801:Humans; D008875:Middle Aged; D011475:Prosthesis Failure; D012086:Reoperation; D013997:Time Factors