Emergency valve replacement during acute carditis--case reports

Two patients are described with acute rheumatic carditis and severe heart failure who failed to respond to aggressive medical treatment with steroids, salicylates, inotropic agents and afterload reduction. In both cases, cardiac catheterization revealed severe aortic and mitral regurgitation with preserved myocardial contractility. Emergency double valve replacement was successfully performed with marked improvement in both patients. The diagnosis and evaluation of the condition, as well as the unique problems confronted in the post-operative course are discussed.