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  • Title: Valve repair for mitral insufficiency secondary to idiopathic juvenile polyarthritis.
    Author: Aubert S, Hayem G, Aumont MC, Brochet E, Acar C.
    Journal: J Heart Valve Dis; 2007 May; 16(3):324-7. PubMed ID: 17578055.
    Abstract:
    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.
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