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[Aortic valve replacement due to Libman-Sacks endocarditis combined with infectious endocarditis]
N Taniyasu1, Y Koh, T Hiramatsu
1Department of Cardiovascular Surgery, Kyoto Second Red-Cross Hospital, Japan.
[Zasshi] [Journal]. Nihon Kyobu Geka Gakkai
|August 1, 1996
Summary
Systemic lupus erythematosus (SLE) can cause Libman-Sacks endocarditis, leading to severe aortic regurgitation. This case highlights successful aortic valve replacement in a patient with SLE and infectious endocarditis.
Area of Science:
- Cardiology
- Rheumatology
- Infectious Diseases
Background:
- A 40-year-old female with a history of Systemic Lupus Erythematosus (SLE), renal failure, and aortic regurgitation presented with symptoms suggestive of active endocarditis.
- The patient had a prior history of pyelonephritis and sepsis caused by E. coli infection.
Observation:
- Preoperative evaluation indicated a non-active phase of SLE.
- Echocardiography and aortography revealed massive aortic regurgitation, necessitating surgical intervention.
- Intraoperative findings included fresh vegetation on the aortic leaflets.
Findings:
- Aortic valve replacement with a Tekna-Edwards 19 mm prosthesis was successfully performed.
- Histopathological examination of the vegetation confirmed both Libman-Sacks endocarditis and infectious endocarditis.
- Intravenous Prednisolone was administered postoperatively to prevent SLE exacerbation.
Implications:
- This case underscores the complex interplay between SLE, Libman-Sacks endocarditis, and superimposed infectious endocarditis.
- Successful surgical management of severe aortic regurgitation in SLE patients is feasible.
- Aggressive management, including valve replacement and immunosuppression, is crucial for favorable outcomes.