Redo aortic valve reconstruction as saving surgery in a patient with severe rheumatoid cardiac disease

The combination of aortic regurgitation, rheumatoid aortitis, and subaortic stenosis is rare in patients with rheumatoid arthritis. Moreover, the surgical treatment of these entities can be challenging and with non-adequate results. We report a case of a patient with severe aortic regurgitation, inaccessible aortic root secondary to rheumatoid aortitis, and severe subaortic stenosis initially treated by aortic valve replacement. We reoperated the patient due to acute prosthetic valve failure by an aortic valve reconstruction using bovine pericardium and Ozaki technique with good outcomes.