Lupus & antiphospholipid syndrome
Severe Libman–Sacks endocarditis complicating antiphospholipid syndrome: a retrospective analysis of 23 operated cases
Authors' conclusion
Severe HVD leading to surgery was strongly associated with thrombotic APS, especially arterial phenotypes. Half of the reported patients presented cerebral stroke complicating the HVD. Valvular surgery carried a significant risk of CAPS.
Study context
- Population
- Adults with SLE and/or APS and severe heart valve disease (incl. Libman-Sacks endocarditis) requiring valvular surgery, with available histopathological report, 1996–201920 females
- Participants
- 23 adults
- Outcome
- Clinical features of SLE and/or APS patients with severe HVD
Methodological detailsobservational, multicentre
- Observational
- Multicentre
Main finding
As reported in the abstract
- Median age, years (range 17-76)
- 37
- APS
- All
- Thrombotic APS
- 22
- Arterial phenotype
- 15
- CAPS
- 6
- SLE
- 11 (47%)
- Systemic disease diagnosed prior to heart valve disease (HVD)
- 12 (52%)
- Cerebral stroke complicating HVD prior to surgery
- 10 (43%)
- Only one pathological valve
- 20 (87%)
- Mitral valve involved
- 18 (78%)
- Valvular thickening
- 19
- Valvular regurgitation
- 19
- Mechanical valve replacement
- 15 (62%)
- Conservative valve repair
- 6 (26%)
- Re-operated after conservative repair (median 1 [0-4] year)
- 5
- Biological valve replacement
- 2 (9%)
- Normal postoperative valvular function
- 18 (78%)
Observational data: associations, not effects.
Safety
Early-onset post-operative complications
- Any early post-operative complication
- 9 (39%)
- CAPS immediately after surgery
- 3
- Death
- 1
Post-operative neurological sequelae · median follow-up 6 [2-20] years
- Patients with neurological sequelae
- 43%
Original publication
Severe Libman–Sacks endocarditis complicating antiphospholipid syndrome: a retrospective analysis of 23 operated cases. Rheumatology (Oxford). Published 10 June 2022. doi:10.
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