Abstract
The increase of mitral valve insufficiency associated with systemic lupus erythematosus
(SLE) seems to be related to the treatment with corticosteroids. Corticosteroids heal
LibmanSacks endocarditis, but thereby they lead to fibrotic, retracted leaflet tissue
and thus to severe valvular dysfunction. We present three patients with SLE who unterwent
mitral valve replacement due to severe mitral insufficiency. All had been treated
with corticosteroids for several years prior to the surgical intervention. Macroscopic
and microscopic examination of the valves revealed no active endocarditis. Instead,
fibrotic, retracted, and calcified valve leaflets could be observed in two cases,
and ballooned and fibrotic leaflets in the third case. We compare our patients to
25 cases with SLE reported in the literature so far, who also had to be submitted
to mitral valve replacement. Postoperative outcome was uneventful in most cases and
allows surgical intervention to be considered as a feasible treatment without major
risk in patients with compensated organ function.
Key words
Systemic lupus erythematosus - Mitral insufficiency - Mitral valve replacement
