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What is the clinical course and postoperative follow-up of aortic regurgitation in patients with severe rheumatoid arthritis?
What is the clinical course and postoperative follow-up of aortic regurgitation in patients with severe rheumatoid arthritis?
Aortic regurgitation in severe rheumatoid arthritis can rapidly cause severe heart failure requiring surgery, with variable long-term postoperative outcomes including potential rheumatoid myocarditis.
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Variable postoperative outcomes in RA-associated AR warrant close surveillance; leaves open myocarditis contribution to late failure.
Three cases of rheumatoid aortic incompetence are reported. All patients had severe rheumatoid arthritis and aortic regurgitation which rapidly caused severe heart failure, requiring surgery within 6 months of the first cardiac symptoms. On surgery, the aortic cusps were thickened and inflammatory and microscopic examination demonstrated foci of fibrinoid necrosis with inflammatory cells. During follow-up, two patients remained asymptomatic (9 months and 6 years after surgery) and one developed severe heart failure, consistent with rheumatoid myocarditis, 3 years after surgery and died one year later.
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Danchin et al. (1987) studied this question.
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