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[A case of mitral valve replacement for Libman-Sacks endocarditis]
1Department of Cardiovascular Surgery, Ehime Central Hospital, Matsuyama, Japan.
[Zasshi] [Journal]. Nihon Kyobu Geka Gakkai
|January 1, 1992
Summary
This case report details a rare instance of Libman-Sacks endocarditis, a complication of Systemic Lupus Erythematosus (SLE), successfully treated with mitral valve replacement surgery.
Area of Science:
- Cardiology
- Rheumatology
- Pathology
Background:
- Systemic Lupus Erythematosus (SLE) is a chronic autoimmune disease that can affect multiple organ systems.
- Libman-Sacks endocarditis (LSE) is a rare valvular manifestation of SLE, characterized by sterile vegetations on heart valves.
- LSE can lead to significant valvular dysfunction and embolic events, posing a diagnostic and therapeutic challenge.
Observation:
- A 38-year-old female with a history of SLE presented with severe dyspnea on effort.
- She had experienced recurrent cerebral infarctions and was diagnosed with massive mitral regurgitation.
- Preoperative evaluation confirmed a non-active SLE phase and severe mitral regurgitation.
Findings:
- Operative findings revealed thrombosed verrucae circumferentially on the mitral valve.
- Histological examination confirmed Libman-Sacks endocarditis.
- Mitral valve replacement with a #27 Carpentier-Edwards prosthesis was performed, reinforcing the mitral annulus with a felt strip.
Implications:
- This case highlights the importance of considering LSE in SLE patients with valvular abnormalities and embolic phenomena.
- Surgical intervention, including valve replacement, can be a viable option for managing severe LSE.
- Early diagnosis and multidisciplinary management are crucial for improving outcomes in patients with LSE.