How to improve our ability to predict adverse events in major surgery of SLE patients?

Monitoring organ damage in systemic lupus erythematosus (SLE) patients addresses the aspect of the disease which is irreversible, independently of its cause: SLE , drugs and/or co-morbidities. Damage accrual correlates with morbidity, mortality and impaired quality of life. Once damage has occurred further deterioration is to be suspected. Cardiovascular (CV) events are considered the first single cause of death in SLE-patients, partly attributable to accelerated atherosclerosis; thus, monitoring traditional and modifiable CV risks in SLE patients is recommended. Damage assessment could be useful in evaluating cardiovascular surgery risks in SLE patients. In this report the clinical course after an ascending aorta and aortic valve replacement in a 32 year-old caucasian woman is described. Perhaps, time has come for a worldwide challenge to create an updated score to quantify damage in SLE patients.