Libman-Sacks型心内膜炎に対して大動脈弁置換術を施行した1例

Aortic Valve Replacement for Libman-Sacks Endocarditis：Report of a Case

はじめに　全身性エリテマトーデス（SLE）は全身性炎症性疾患であり，さまざまな合併症を認め，心血管系疾患を合併した報告もある．われわれは，22年間のSLEの加療中に大動脈弁狭窄兼閉鎖不全症（ASr）を合併した1例を経験したので報告する．

A 36-year-old woman with severe aortic valve stenosis was admitted to our hospital. She had been diagnosed with antiphospholipid syndrome complicated with systemic lupus erythematosus （SLE） and had been taking prednisolone （10 mg/day） for 22 years. As SLE patients with prolonged steroid use are known to be at risk of an aortic dissection and aneurysm, femoral artery was chosen for arterial perfusion to reduce a risk of aortic dissection. Aortic valve replacement was performed uneventfully, because the aorta was treated carefully during the operation. Negative microbial culture and pathological examination of the resected aortic valve demonstrated an atypical vegetation, the findings of which were typically characteristic of Libman-Sacks endocarditis in SLE. She was discharged without complications 23 days after the operation.