Related Experiment Video
Updated: May 21, 2026

Investigating Aortic Valve Calcification via Isolation and Culture of T Lymphocytes using Feeder Cells from Irradiated Buffy Coat
Published on: February 4, 2021
Aortic Valve Neocuspidization in Libman-Sacks Endocarditis
Mohammed Sanad1, Mohamed A Gabr1, Sameh M Said2
1Faculty of Medicine, Department of Cardiothoracic Surgery, Mansoura University, Mansoura, Egypt.
Background:
Libman-Sacks endocarditis (LSE) is a noninfective thrombotic endocarditis frequently associated with antiphospholipid syndrome (APS) and/or systemic lupus erythematosus. Valvular obstruction, if it occurs, may require urgent surgery.
Case Summary:
Two women with APS and systemic lupus erythematosus presented with severe aortic valve (AV) obstruction due to LSE. Both underwent AV neocuspidization (AVNeo) using the autologous pericardium "Ozaki technique." The procedures were successful, and the postoperative course was uneventful for each. At the 2- and 3-year follow-up, both patients were doing well with good AV function and maintained competence.
Discussion:
Mechanical valves are traditionally preferred for APS patients because of the inherent need for lifelong anticoagulation. However, AVNeo may offer superior hemodynamics, avoidance of traditional lifelong warfarin therapy, and improved quality of life, particularly in younger patients desiring pregnancy. To our knowledge, these cases represent the first reported AVNeo cases for LSE.
Take-Home Message:
AVNeo represents a promising surgical alternative in APS-associated LSE, combining favorable outcomes and potential anticoagulation benefits.
Related Concept Videos
Endocarditis II: Clinical Features of Infective Endocarditis
Endocarditis I: Introduction
Aortic Regurgitation I: Introduction
Mitral Stenosis I: Introduction
Endocarditis III: Medical Management
Aortic Regurgitation II: Clinical Features and Diagnostic Tests
