Concomitant aortic valve replacement, mitral valve replacement, and coronary artery bypass grafting for aortic stenosis and mitral regurgitation in a patient with relapsing polychondritis

Gen Thorac Cardiovasc Surg. 2020 Feb;68(2):185-189. doi: 10.1007/s11748-019-01130-6. Epub 2019 Apr 30.

Abstract

Relapsing polychondritis is a rare multi-system disease characterized by inflammation in cartilaginous structures and other connective tissues. Cardiovascular complications occur in 10-51% of the patients. We report a case of concomitant aortic valve replacement, mitral valve replacement, and coronary artery bypass grafting in a patient with relapsing polychondritis. A 71-year-old female with relapsing polychondritis on prednisolone (5 mg/day) for 15 years presented at our hospital for further evaluation of valvular disease. Severe aortic stenosis and severe mitral regurgitation were diagnosed. We performed aortic and mitral valve replacement. During surgery, we found connective tissue surrounding the intima of the sinus of Valsalva and stenosis of the right coronary artery ostium, which was not noted on preoperative coronary angiography. We removed the tissue and performed bypass grafting to the right coronary artery. Postoperative recovery was uneventful, and she was discharged 27 days after surgery.

Keywords: Aortic valve stenosis; Coronary artery bypass; Heart valve prosthesis implantation; Mitral valve insufficiency; Relapsing polychondritis.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Aortic Valve / surgery*
  • Aortic Valve Stenosis / surgery*
  • Coronary Angiography
  • Coronary Artery Bypass*
  • Female
  • Heart Valve Prosthesis
  • Heart Valve Prosthesis Implantation
  • Humans
  • Mitral Valve / surgery*
  • Mitral Valve Insufficiency / diagnostic imaging
  • Mitral Valve Insufficiency / surgery*
  • Polychondritis, Relapsing / diagnostic imaging
  • Polychondritis, Relapsing / surgery*