Mitral valve surgery for mitral regurgitation caused by Libman-Sacks endocarditis: a report of four cases and a systematic review of the literature

Bouma, Wobbe; Klinkenberg, Theo J; van der Horst, Iwan CC; Wijdh-den Hamer, Inez J; Erasmus, Michiel E; Bijl, Marc; Suurmeijer, Albert JH; Zijlstra, Felix; Mariani, Massimo A

doi:10.1186/1749-8090-5-13

Table 2 Systematic review of the English literature on mitral valve surgery for (isolated) MR caused by Libman-Sacks endocarditis^a

From: Mitral valve surgery for mitral regurgitation caused by Libman-Sacks endocarditis: a report of four cases and a systematic review of the literature

Reference	Year published	Gender/ Age (years)	SLE and/ or APS	Years of SLE and/or APS	Steroids	MR grade^b	MVR/MVP	Surgical procedure	Follow-up
Myerowitz et al [48]	1974	F/22	SLE	3	yes	4+	MVR	Reis-Hancock porcine bioprosthesis	alive 2 months post-op
Murray et al [49]	1975	F/43	SLE	2	yes	4+	MVR	Beall Surgitoul mechanical prosthesis	alive 6 months post-op
Paget et al [50]	1975	F/18	SLE	4	yes	4+	MVR	Porcine xenograft (bioprosthesis)	alive 4 months post-op
Kinney et al [51]	1980	F/27	SLE	0.3	no	4+	MVR	Hancock porcine bioprosthesis	NR
Rawsthorne et al [52]	1981	M/51	SLE	21	no	4+	MVR^c	Hancock porcine bioprosthesis	NR
Brennan et al [53]	1983	F/20	SLE	2	yes	4+	MVR	Björk-Shiley mechanical prosthesis	CVA 17 months post-op
Rozman et al [54]	1986	M/43	SLE	2	yes	NR	MVR	Starr-Edwards mechanical prosthesis	alive 4 years post-op
Moynihan et al [55]	1988	F/54	SLE	2	yes	4+	MVR^c	Carpentier-Edwards porcine bioprosthesis	alive 26 months post-op
Straaton et al [56]	1988	F/22	SLE	<1	no	4+	MVR^d	Carpentier-Edwards heterograft (bioprosthesis)	NR
		F/67	SLE	10	yes	2+/3+	MVR^c	St. Jude mechanical prosthesis	died intraoperatively
Ferraris et al [57]	1990	M/34	SLE	9	yes	4+	MVR	Carpentier-Edwards bioprosthesis	alive 2.5 years post-op
Alvarez et al [58]	1994	F/42	APS	1	no	2+/3+	MVR	Medtronic Hall mechanical prosthesis	NR
Kalangos et al [40]	1995	F/28	SLE	0.5	yes	4+	MVP	Resection of the prolapsed posterior commissure and restoration with an autologous pericardial patch; sliding plasty of the anterior leaflet; transposition of secondary chordae to the commisure; Carpentier- Edwards annuloplasty ring	no MR recurrence 1 year post-op
Chauvaud et al [41]	1995	F/17	SLE	5	yes	4+	MVP	Posterior leaflet enlargement with pericardial patch and Carpentier-Edwards annuloplasty ring	MS 6 months post-op due to calcification
							redo MVR	Cryopreserved homograft	alive 1 year post-op
Shahian et al [59]	1995	F/29	APS	0	yes	4+	MVR	St. Jude mechanical prosthesis	alive 2 years post-op
Gordon et al [46]	1996	M/37	SLE, APS	>2	yes	1+/2+	MVR^c	Carpentier-Edwards porcine bioprosthesis	recurrent A-V fistula
							redo MVR	Carpentier-Edwards porcine bioprosthesis	died 1 month post-op
Morin et al [33]	1996	F/40	SLE	12	yes	4+	MVR	St. Jude mechanical prosthesis	alive 2 weeks post-op
East et al [60]	2000	F/51	SLE, APS	NR	no	4+	MVR^e	not further specified	NR
		F/49	SLE, APS	7	yes	4+	MVR	not further specified	NR
Hakim et al [42]	2001	F/23	SLE	8	yes	4+	MVR	St. Jude mechanical prosthesis	alive >1 year post-op
		F/54	SLE	7	yes	4+	MVP^f	not further specified	MR 29 months post-op
							redo MVR	St. Jude mechanical prosthesis	alive >5 years post-op
		F/64	SLE	2	yes	4+	MVP^e	Quadrangular resection of the posterior leaflet and Duran annuloplasty ring	alive >3 years post-op
Kato et al [43]	2001	F/52	APS	NR	no	4+	MVP	Kay's annuloplasty and Cosgrove annuloplasty ring	alive 3 months post-op
Mottram et al [23]	2002	M/50	APS	0	no	0/1+	MVP	Removal of two mitral valve masses	alive 9 weeks post-op
da Silva et al [47]	2003	F/54	SLE, APS	13	yes	4+	MVR	Bioprosthesis (not further specified)	bioprosth. thrombosis and death 9 months post-op
Schneider et al [44]	2003	M/23	SLE	NR	NR	4+	MVP	not further specified	NR
Georghiou et al [61]	2003	F/44	SLE	1	yes	3+	MVR^c,d	St. Jude mechanical prosthesis	alive 6 months post-op
Bordin et al [62]	2003	F/57	SLE, APS	3	NR	4+	MVR	Mechanical prosthesis (not further specified)	MI 2 days post-op
Berkun et al [63]	2004	F/48	APS	NR	yes	3+/4+	MVR	Carbomedics mechanical prosthesis	MR 90 months post-op
							redo MVR	not further specified	died 6 months post-op
		F/73	APS	NR	yes	3+/4+	MVR	Hancock porcine bioprosthesis	died 13 months post-op
		F/47	APS	NR	yes	3+/4+	MVR^c	Carbomedics mechanical prosthesis	splenic embolus 3 and CVA 10 months post-op alive 42 months post-op
		F/38	SLE, APS	NR	yes	3+/4+	MVR	Carbomedics mechanical prosthesis	alive 32 months post-op
		F/51	SLE, APS	NR	yes	3+/4+	MVR	Carbomedics mechanical prosthesis	alive 33 months post-op
Fernández et al [45]	2005	F/36	SLE	8	NR	4+	MVP	not further specified	mild MR 1 year post-op
Taguchi et al [24]	2006	F/34	SLE	9	yes	0/1+	MVP	Resection of A3 and attached chordae (en-bloc); restoration of the anterior leaflet; 4 PTFE neochordae	no MR recurrence 6 months post-op
Einav et al [64]	2007	F/28	SLE, APS	4.5	yes	4+	MVR^c,d	Mechanical prosthesis (not further specified)	NR
Takayama et al [16]	2008	M/58	SLE, APS	0	no	3+/4+	MVP	Valvuloplasty and annuloplasty (not further specified)	NR
Bouma et al	2010	M/49	SLE	1.5	yes	4+	MVP	Quadrangular resection of the posterior stable trace MR leaflet (P2) and Carpentier-Edwards annuloplasty ring	stable trace MR 11 years post-op
		M/56	SLE	4	yes	4+	MVR	St. Jude mechanical prosthesis	alive >1.5 years post-op
		F/28	APS	1	no	4+	MVR	St. Jude mechanical prosthesis	alive >1.5 years post-op
		F/22	APS	0.5	no	2+	MVP	Quadrangular resection of the posterior leaflet (P2) and Cosgrove-Edwards annuloplasty ring	no MR recurrence 1.5 years post-op

A-V, atrioventricular; APS, antiphospholipid syndrome; CVA, cerebrovascular accident; F, female; M, male; MI, myocardial infarction; MR, mitral regurgitation; MS, mitral stenosis;MVP, mitral valve plasty; MVR, mitral valve repair; NR, not reported; PTFE, polytetrafluorethylene; SLE, systemic lupus erythematosus
^areports not written in English or reports of mitral valve surgery in patients with SLE and/or APS without a description of MR etiology and mitral valve pathology were excluded; cases of MS (n = 4) or combined MR/MS (n = 11) caused by Libman-Sacks endocarditis were also excluded
^bMR severity grading: 0, no or trace MR; 1+, mild MR; 2+, moderate MR; 3+, moderate-to-severe MR; 4+, severe MR
^cincluding aortic valve replacement (AVR)
^dincluding tricuspid valve plasty (TVP)
^eincluding CABG
^fincluding aortic valve plasty (AVP)

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