Ankylosing Spondyloarthritis Resulting Severe Aortic Insufficiency and Aortitis: Exacerbation of Ankylosing Spondyloarthritis and Stenosis of the Main Left Coronary Artery after Mechanical Aortic Valve Implantation with Cardiopulmonary Bypass

Agnė Balčiūnaitė; Algimantas Budrikis; Eglė Rumbinaitė; Jurgita Sabaliauskienė; Vaiva Patamsytė; Vaiva Lesauskaitė

doi:10.1155/2020/9538527

Ankylosing Spondyloarthritis Resulting Severe Aortic Insufficiency and Aortitis: Exacerbation of Ankylosing Spondyloarthritis and Stenosis of the Main Left Coronary Artery after Mechanical Aortic Valve Implantation with Cardiopulmonary Bypass

Case Rep Rheumatol. 2020 Jan 3:2020:9538527. doi: 10.1155/2020/9538527. eCollection 2020.

Authors

Agnė Balčiūnaitė¹, Algimantas Budrikis¹, Eglė Rumbinaitė², Jurgita Sabaliauskienė³, Vaiva Patamsytė⁴, Vaiva Lesauskaitė⁴

Affiliations

¹ Department of Cardiac, Thoracic and Vascular Surgery, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania.
² Department of Cardiology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania.
³ Department of Rheumatology, Lithuanian University of Health Sciences, Kaunas, Lithuania.
⁴ Institute of Cardiology of the Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania.

Abstract

Ankylosing spondyloarthritis (AS) is a chronic inflammatory rheumatic disease, strongly related to human leukocyte antigen (HLA)-B27. Cardiac involvement in AS manifests in 2 to 10% of patients as aortic insufficiency, aortitis, mitral valve fibrosis, or disturbance in the conduction of the heart. In this article, we present a case of a 49-year-old male patient with AS, who was referred to our medical institution for elective aortic valve surgery because of severe aortic regurgitation. The histological findings revealed fibrosing endocarditis of aortic valve and nonspecific aortitis of aortic root. Late postoperatively, we observed exacerbation of AS and narrowing of the main left coronary artery (LAD). Our case highlights the importance of proper treatment of AS before and after cardiac surgery. Furthermore, in this case, we suspect association between cardiopulmonary bypass, activity of AS, and coronary artery disease.

Publication types

Case Reports