Surgical Treatment of Mitral Valve Disease in Patients with Systemic Lupus Erythematosus

Objectives: Systemic lupus erythematosus (SLE) is a chronic autoimmune disorder that impacts various organ systems. The most prevalent cardiac symptom in SLE is valve involvement, which raises serious concerns. One defining hallmark is Libman–Sacks endocarditis. The structural damage to the valves and associated conditions such as lupus nephritis and antiphospholipid antibody (APL) syndrome determine the course of surgical management. Evaluation of outcomes and complications of surgical management of mitral valve disease in SLE. Material and Methods: We have analyzed 5 patients of SLE with concomitant mitral valve disease who presented to the Department of Cardiothoracic Surgery at Nizam’s Institute of Medical Sciences between 2018 and 2024. Data from the case records and follow-up records were collected, and a detailed evaluation was done. Results: In this study, we report 5 cases of SLE with concomitant mitral valve disease. Four patients had mitral regurgitation (MR) as the primary pathology, whereas one patient had mitral valve stenosis due to coexisting rheumatic heart disease. Of the 4 patients with MR, APL syndrome was noted in one patient while another patient had an ongoing lupus nephritis. All the 5 patients in the study were females with a mean age of 27.6 years (range: 13–36). The most common presenting complaint was dyspnea on exertion. All the patients were managed surgically with satisfactory outcomes. Mitral valve repair was done in 1 patient (20%), whereas a valve replacement was done in 4 patients (80%). A bio-prosthetic valve was used in 2 patients and a mechanical valve was used in 2 other patients. One patient underwent concomitant tricuspid valve repair. Conclusion: Surgical intervention for mitral valve pathology in patients with SLE is justified to alleviate symptoms and reduce the risk of thromboembolic events. Timely surgical management significantly enhances a patient’s quality of life.