Mitral valve replacement and repair - Report of 5 patients with systemic lupus erythematosus

Severe mitral valve regurgitation due to systemic lupus erythematosus is a rare cause of valvular heart disease, necessitating valve surgery. Currentl y there are 36 case reports in the world medical literature of mitral valve replacement or repair in patients who have lupus. The current trend in mit ral valve surgery is toward anatomic valve repair, in patients who have sys temic lupus erythematosus, however, valve repair often leads to repeat surg ery and valve replacement. We report the cases of 5 patients with lupus and severe mitral valve regurgitation who underwent mitral valve surgery. In 3 of these patients, replacement with a mechanical prosthetic mitral valve w as performed with good long-term results. In the other 2 patients, mitral v alve repair was performed, but only 1 of the repairs was successful. The 2n d patient required subsequent replacement with a mechanical valve. To our knowledge, this report of 5 patients is the largest series of mitral valve surgery in patients with lupus. These results, along with a review o f the literature, suggest the superiority of mechanical prosthetic valve re placement to repair in patients who have systemic lupus erythematosus.