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Published on: September 15, 2023
Coronary artery bypass grafting in patients with systemic lupus erythematosus
Nilgün Bozbuğa1, Vedat Erentuğ, Erhan Kaya
1Department of Cardiovascular Surgery, Koşuyolu Heart and Research Hospital, Istanbul, Turkey. nbozbuga@kosuyolu.gov.tr
Insights
Systemic lupus erythematosus (SLE) patients can undergo successful coronary artery bypass grafting (CABG). Two SLE patients with coronary artery disease had good outcomes after CABG, one with cardiopulmonary bypass and another off-pump during hemodialysis.
Area of Science:
- Cardiology
- Rheumatology
- Surgical Innovation
Background:
- Coronary artery disease (CAD) is a significant cause of mortality in patients with systemic lupus erythematosus (SLE).
- Surgical management of CAD in SLE patients presents unique challenges.
- Limited data exists on the outcomes of coronary artery bypass grafting (CABG) in SLE patients.
Observation:
- Two female SLE patients, aged 45 and 39, presented with significant coronary artery disease.
- The first patient had left main and two-vessel coronary disease requiring CABG with cardiopulmonary bypass.
- The second patient, undergoing hemodialysis, underwent successful off-pump CABG.
Findings:
- Both SLE patients demonstrated successful outcomes following coronary artery bypass grafting.
- The use of cardiopulmonary bypass and off-pump techniques were both feasible in this patient cohort.
- Postoperative recovery was uncomplicated in both cases, suggesting good surgical tolerability.
Implications:
- CABG is a viable and safe treatment option for selected SLE patients with coronary artery disease.
- Off-pump CABG may be a suitable alternative, particularly for patients with comorbidities like those requiring hemodialysis.
- Further research is warranted to establish optimal surgical strategies and long-term outcomes for SLE patients undergoing CABG.
Abstract:
Coronary artery disease remains a major cause of mortality and morbidity with systemic lupus erythematosus (SLE). We report two cases of coronary artery bypass grafting (CABG) associated with SLE. The first patient (a 45-year-old woman) underwent CABG operation for left main and two-vessel coronary disease using cardiopulmonary bypass. Successful CABG was done using off-pump technique in the second patient (a 39-year-old woman) under hemodialysis therapy. Both patients showed good postoperative outcome without complications.
