Mitral valve replacement for mitral stenosis caused by Libman-Sacks endocarditis.

Vaughton, K. C.; Walker, D R; Sturridge, M. F.

doi:10.1136/hrt.41.6.730

Cited by 33 publications

(4 citation statements)

References 12 publications

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“…In all 5 cases, a valvular replacement was performed and a bivalve mechanical prosthesis was implanted. Reports of valvular surgery in SLE patients are scarce: only about 50 cases have been reported, mostly individual case reports (16–46). Our series of 5 patients is the same size as the largest previously published (41).…”

Section: Discussionmentioning

confidence: 99%

Severe valvular regurgitation and antiphospholipid antibodies in systemic lupus erythematosus: A prospective, long-term, followup study

Pérez‐Villa¹,

Font²,

Azqueta³

et al. 2005

Arthritis Rheum

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Objective. To assess whether the presence of antiphospholipid antibodies is related to the incidence and progression of severe valvular dysfunction and the need for valve replacement in patients with systemic lupus erythematosus (SLE). Methods. In this prospective, long-term followup study, the initial echocardiographic findings in a cohort of 61 consecutive SLE patients were compared with those of 40 matched controls. All patients were serially evaluated for 14 ؎ 3 years and had a followup echocardiogram 8 ؎ 3 years after the initial evaluation. Serial determinations of anticardiolipin antibodies and lupus anticoagulant were performed in all cases. Results. The number of SLE patients with valvular abnormalities increased from 39% to 73% between the initial and the followup echocardiography, but only 7 patients (12%) developed severe valvular regurgitation. Severe valvular regurgitation was significantly associated with the presence of high levels of IgG anticardiolipin antibodies (P ‫؍‬ 0.001). The combined incidence of stroke, peripheral embolism, need for valve surgery, and death was 86% in patients with severe valvular regurgitation, compared with 25% in those without (P ‫؍‬ 0.003). Conclusion. In SLE patients, the presence of high levels of IgG anticardiolipin antibodies is associated with the development of severe valvular regurgitation and with a high incidence of thromboembolic events and the need for valvular surgery.

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Section: Discussionmentioning

confidence: 99%

Severe valvular regurgitation and antiphospholipid antibodies in systemic lupus erythematosus: A prospective, long-term, followup study

Pérez‐Villa¹,

Font²,

Azqueta³

et al. 2005

Arthritis Rheum

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“…Cases with APLS and valve operation are listed in Table 4, some more are mentioned in literature but without sufficient or available further information [53,76,77,[79][80][81][82][83][84], hidden unseparated as SLE patients [85][86][87] or declared APLS on basis of lab tests without clinical signs [88,89]. Most of the papers are single case reports, the largest series with 10 patients was published by Berkun et al [90].…”

Section: Review Of Literature -Not Easy To Reconcilementioning

confidence: 98%

The antiphospholipid syndrome and heart valve surgery

Gorki¹,

Malinovski²,

Stanbridge³

2008

European Journal of Cardio-Thoracic Surgery

125

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The antiphospholipid syndrome (APLS) is a complex autoimmune disease often connected to systemic lupus erythematodes. Main features are thromboses, fetal loss and specific antibodies. The involved autoantibodies are directed against plasma proteins such as beta2glycoprotein1 (beta2GPI) or prothrombin which depend on negatively charged phospholipids. Direct antibodies against phospholipids are of no importance for APLS. Clotting tests such as activated partial thromboplastin time or diluted Russell's viper venom test (dRVVT) can show a prolonged time for coagulation despite a prothrombotic state in vivo but the investigator needs awareness about disturbing phospholipid sources and other influential factors. Enzyme linked immuno sorbent assay tests for antibodies against cardiolipin, beta2GPI and prothrombin are valuable solid phase tests with different specificity. Antiphospholipid, anticardiolipin or lupus anticoagulant are misnomers in connection with APLS. They are preserved as a reminiscence of the pioneering work on the way to the still not exactly revealed basics of APLS. Valve operations in APLS patients seem to be rare; a meta-analysis of 57 cases proves that the perioperative management is, at the moment, an empirical approach with high morbidity and mortality in these young patients.

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“…Lesions are haemodynamically significant in only 3–4% of SLE patients, requiring surgical excision 90. There is no direct evidence that treatment with steroids can prevent valvular damage; however, the decline in prevalence of Libman–Sacks lesions at autopsy following the introduction of corticosteroids supports a possible indirect beneficial role 91.…”

Section: Valvular Heart Disease/lupus Endocarditismentioning

confidence: 99%

Cardiac pathology of systemic lupus erythematosus

Jain

Halushka²

2009

J Clin Pathol

107

102

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Systemic lupus erythematosus is a common chronic autoimmune disorder causing injury to many organ systems. Cardiac complications of lupus affect most parts of the heart. These include pericarditis, myocarditis, endocarditis and coronary artery disease. While many histopathological findings in lupus-related cardiac diseases are non-specific, there are a few important findings which pathologists should be aware of. This review provides pathological descriptions of these entities.

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Mitral valve replacement for mitral stenosis caused by Libman-Sacks endocarditis.

Cited by 33 publications

References 12 publications

Severe valvular regurgitation and antiphospholipid antibodies in systemic lupus erythematosus: A prospective, long-term, followup study

Severe valvular regurgitation and antiphospholipid antibodies in systemic lupus erythematosus: A prospective, long-term, followup study

The antiphospholipid syndrome and heart valve surgery

Cardiac pathology of systemic lupus erythematosus

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