Abstract
BACKGROUND: Cardiac involvement in juvenile idiopathic arthritis (JIA) is very rare but potentially life-threatening, and cases dominated by aortic regurgitation are particularly uncommon. CASE SUMMARY: We describe the case of a 9-year-old girl with severe aortic regurgitation secondary to JIA. Her overall condition improved after cardiac surgical intervention combined with perioperative immunosuppressive therapy. DISCUSSION: This case highlights the rare severe aortic regurgitation in JIA. Our management of this 12-year-old girl demonstrates the effectiveness of a staged approach combining perioperative immunosuppression with appropriately timed surgical intervention. The mechanical valve selection was strategic, considering the deterioration risk of bioprosthetic valves and reported immunological failures with Ross procedures in this population. This case emphasizes 4 critical principles: early cardiac screening in patients with JIA, timely surgical intervention, essential immunosuppressive therapy, and multidisciplinary management. TAKE-HOME MESSAGE: We suggest that patients with JIA should undergo regular echocardiographic monitoring, and timely cardiac surgery should be considered in cases of severe valvular involvement.