Dajee H, Hurley E J, Szarnicki R J
J Thorac Cardiovasc Surg. 1983 May;85(5):718-26.
Three cases of cardiac valve replacement for Libman-Sacks endocarditis and their long-term follow-up are described. From the review of the literature, an additional nine patients who required cardiac valve replacement are studied. Steroids probably increase the incidence of valve incompetence, but most patients presumably die of other associated organ involvement before undergoing a cardiac operation. Operation is indicated because of change in the intensity or character of the murmur, and a new murmur with resultant, resistant congestive cardiac failure. Both the aortic and mitral valves should be explored. Valve reconstruction in these young patients, with the expectation of avoiding prosthetic valve dysfunction and repeat operation, is not possible. Bioprosthetic valve replacement may be preferable, since it eliminates the need for anticoagulation during steroid treatment. Overall mortality was 25%.
本文描述了三例因Libman-Sacks心内膜炎行心脏瓣膜置换术及其长期随访情况。通过文献回顾，还研究了另外九例需要进行心脏瓣膜置换术的患者。类固醇可能会增加瓣膜关闭不全的发生率，但大多数患者可能在接受心脏手术前死于其他相关器官受累。因杂音强度或性质改变以及出现新杂音并导致难治性充血性心力衰竭而需进行手术。主动脉瓣和二尖瓣均应进行探查。对于这些年轻患者，期望避免人工瓣膜功能障碍和再次手术而进行瓣膜重建是不可能的。生物人工瓣膜置换可能更可取，因为它消除了类固醇治疗期间抗凝的必要性。总体死亡率为25%。
