mycophenolic-acid and Aortic-Valve-Insufficiency

Cardiovascular involvement occurring in 20-30% patients is the second most common cause of mortality in patients with relapsing polychondritis. Aortic insufficiency occurs as a result of aortic root dilatation rather than primary valvular involvement. We are reporting a patient of relapsing polychondritis with aortic root dilatation, in whom institution of early and aggressive therapy successfully prevented the progression of aortic insufficiency.

Topics: Aorta; Aortic Diseases; Aortic Valve Insufficiency; Azathioprine; Cyclophosphamide; Dilatation, Pathologic; Drug Substitution; Drug Therapy, Combination; Glucocorticoids; Humans; Immunosuppressive Agents; Male; Methylprednisolone; Middle Aged; Mycophenolic Acid; Polychondritis, Relapsing; Prednisolone

A 65-year-old male was admitted to our hospital for surgical treatment of congestive heart failure with aortic regurgitation. He had received renal transplantation 15 years before in the United States, and had been under immunosuppressive regimen with ciclosporin and mycophenolate mofetil. Although the renal allograft function had been gradually deteriorating, and preoperative serum creatinine level was 1.8 mg/dl, and it decreased to 1.5 mg/dl after aortic valve replacement. Cryopreserved aortic allograft was needed for the aortic valve replacement. The reasons are; the patient may need hemodialysis (HD) or retransplantation of the kidney in the future, and the immunosuppressive therapy for kidney will provide good immunologic environment for second allograft, i.e.--aortic valve. He tolerated the operation well and the immunosuppressive agents were continued in the perioperative period. He is now in New York Heart Association (NYHA) class I.

Topics: Aged; Aortic Valve; Aortic Valve Insufficiency; Cyclosporine; Heart Failure; Humans; Immunosuppressive Agents; Kidney Transplantation; Male; Methylprednisolone; Mycophenolic Acid; Time Factors; Transplantation, Homologous