Yoshida M, Sasako Y, Kobayashi J, Minatoya K, Bando K, Kitamura S
Department of Cardiovascular Surgery, National Cardiovascular Center, Osaka, Japan.
Jpn J Thorac Cardiovasc Surg. 2000 Jun;48(6):391-3. doi: 10.1007/BF03218164.
The first case was of a 27-year-old female, who was diagnosed as having mitral valve stenosis with regurgitation, systemic lupus erythematosus and antiphospholipid syndrome at her previous pregnancy. We performed mitral valve plasty, which included open mitral commissurotomy and Kay's annulo plasty. The second case was of a 53-year-old female, who was diagnosed as old myocardial infarction, mitral regurgitation, systemic lupus erythematosus and antiphospholipid syndrome. She underwent mitral valve plasty and coronary artery bypass grafting. Both cases were treated by administration of methylpredonisolone and heparin perioperatively to avoid thrombosis and aggravation of systemic lupus erythematosus. Both patients showed good postoperative outcome without complications. We consider that it is important to perform the plasty as far as possible, and to administer effective anticoagulation treatment to prevent complications for patients in the setting of systemic lupus erythematosus and antiphospholipid syndrome.
第一例是一名27岁女性,她在之前怀孕时被诊断为二尖瓣狭窄伴反流、系统性红斑狼疮和抗磷脂综合征。我们进行了二尖瓣成形术,包括开放式二尖瓣交界切开术和凯氏瓣环成形术。第二例是一名53岁女性,她被诊断为陈旧性心肌梗死、二尖瓣反流、系统性红斑狼疮和抗磷脂综合征。她接受了二尖瓣成形术和冠状动脉搭桥术。两例患者均在围手术期给予甲泼尼龙和肝素治疗,以避免血栓形成和系统性红斑狼疮加重。两名患者术后恢复良好,无并发症。我们认为,对于患有系统性红斑狼疮和抗磷脂综合征的患者,尽可能进行成形术并给予有效的抗凝治疗以预防并发症非常重要。