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Updated: Sep 22, 2025
14:14
Standardized Technique of Aortic Valve Re-implantation for Valve-sparing Aortic Root Replacement
Published on: December 11, 2017
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[Aortic Valve Replacement for Libman-Sacks Endocarditis:Report of a Case]
Shuichi Okada1, Masahiko Ezure, Yutaka Hasegawa
1Department of Cardiovascular Surgery, Gunma Prefectural Cardiovascular Center, Maebashi, Japan.
Kyobu Geka. the Japanese Journal of Thoracic Surgery
|May 26, 2022
Summary
This case study highlights a successful aortic valve replacement in a patient with antiphospholipid syndrome and systemic lupus erythematosus (SLE). Careful surgical technique mitigated risks associated with long-term steroid use and potential aortic complications.
Area of Science:
- Cardiology
- Rheumatology
- Cardiovascular Surgery
Background:
- Systemic lupus erythematosus (SLE) patients on long-term prednisolone are at increased risk for aortic dissection and aneurysm.
- Severe aortic valve stenosis necessitates surgical intervention.
- Antiphospholipid syndrome (APS) is an autoimmune condition that can affect multiple organ systems.
Observation:
- A 36-year-old woman with APS-SLE on chronic prednisolone presented with severe aortic valve stenosis.
- Femoral artery cannulation was chosen for arterial perfusion to minimize aortic dissection risk.
- The patient underwent aortic valve replacement with careful aortic manipulation.
Findings:
- The surgery was uneventful, with no complications.
- Pathological examination of the resected valve revealed atypical vegetation, characteristic of Libman-Sacks endocarditis.
- Microbial cultures were negative.
Implications:
- This case demonstrates the feasibility and safety of aortic valve replacement in SLE patients with APS.
- Highlights the importance of tailored surgical approaches in patients with connective tissue diseases and long-term steroid use.
- Emphasizes the need for vigilance regarding cardiovascular manifestations, such as Libman-Sacks endocarditis, in SLE patients.
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