Key result
Aortic valve neocuspidization via Ozaki technique maintains good function in Libman-Sacks endocarditis at three years.
Why the study?
Libman-Sacks endocarditis can cause valvular obstruction requiring urgent surgery, but the role of aortic valve neocuspidization in these patients had not been reported.
Does aortic valve neocuspidization provide favorable outcomes in patients with severe aortic valve obstruction due to Libman-Sacks endocarditis?
Case Report (n=2)
Does aortic valve neocuspidization provide favorable outcomes in patients with severe aortic valve obstruction due to Libman-Sacks endocarditis?
Aortic valve neocuspidization (Ozaki technique) may be a promising surgical alternative to mechanical valves in patients with APS-associated Libman-Sacks endocarditis, potentially avoiding lifelong warfarin therapy.
BACKGROUND: Libman-Sacks endocarditis (LSE) is a noninfective thrombotic endocarditis frequently associated with antiphospholipid syndrome (APS) and/or systemic lupus erythematosus. Valvular obstruction, if it occurs, may require urgent surgery. CASE SUMMARY: Two women with APS and systemic lupus erythematosus presented with severe aortic valve (AV) obstruction due to LSE. Both underwent AV neocuspidization (AVNeo) using the autologous pericardium "Ozaki technique." The procedures were successful, and the postoperative course was uneventful for each. At the 2- and 3-year follow-up, both patients were doing well with good AV function and maintained competence. DISCUSSION: Mechanical valves are traditionally preferred for APS patients because of the inherent need for lifelong anticoagulation. However, AVNeo may offer superior hemodynamics, avoidance of traditional lifelong warfarin therapy, and improved quality of life, particularly in younger patients desiring pregnancy. To our knowledge, these cases represent the first reported AVNeo cases for LSE. TAKE-HOME MESSAGE: AVNeo represents a promising surgical alternative in APS-associated LSE, combining favorable outcomes and potential anticoagulation benefits.
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Sanad et al. (2026) conducted a case report in Libman-Sacks endocarditis (n=2). Aortic valve neocuspidization (AVNeo) using autologous pericardium (Ozaki technique) was evaluated on Procedural success and aortic valve function. Aortic valve neocuspidization using the Ozaki technique was successfully performed in two women with Libman-Sacks endocarditis, maintaining good valve function at 2- and 3-year follow-up.
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