Antiphospholipid Syndrome, Severe Aortic Stenosis with Infective Endocarditis: A Triple Jeopardy (A Therapeutic Challenge)

Primary antiphospholipid antibody syndrome is rare and manifests with involvement of cardiac valves, coronaries and thrombophilia. We are reporting a case who presented with thrombo - embolism at multiple sites, bicuspid aortic valve with severe aortic stenosis and large vegetation over aortic valve involving triple jeopardy. These cases carry high risk of surgical intervention. Preoperatively she was covered with oral anticoagulants and bridged with low molecular heparin to prevent thromboembolism and risk of bleeding. She had successful minimally invasive aortic valve replacement with concomitant antibiotics and vitamin K antagonists. Multidisciplinary team approach is needed in their management.