Severe mitral regurgitation from Libman–Sacks endocarditis treated with MitraClip: a case report

Abstract Background  Systemic lupus erythematosus (SLE) valvulopathy can manifest as a spectrum of pathologies and treatment of severe valvular dysfunction thus far has been surgical. However, surgery in patients with SLE is frequently associated with high morbidity and mortality due to the presence...

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Bibliographic Details
Published in:European heart journal : case reports 2021-10, Vol.5 (10), p.ytab361
Main Authors: Ningyan, Wong, Jappar, Ignasius Aditya, See Hooi, Ewe, Khung Keong, Yeo
Format: Article
Language:English
Subjects:
Care and treatment
Case Report
Endocarditis
Health aspects
Heart failure
Lupus
Mitral valve insufficiency
Mortality
Rivaroxaban
Stroke (Disease)
Systemic lupus erythematosus
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Summary:Abstract Background  Systemic lupus erythematosus (SLE) valvulopathy can manifest as a spectrum of pathologies and treatment of severe valvular dysfunction thus far has been surgical. However, surgery in patients with SLE is frequently associated with high morbidity and mortality due to the presence of significant co-morbidities. Case summary  We report the case of a 41-year-old woman with SLE and anti-phospholipid syndrome with extensive co-morbidities including lupus nephritis, pancytopaenia, cerebrovascular accident, and severe airway obstruction from ipsilateral lung collapse and bronchiectasis. She had severe mitral regurgitation (MR) from Libman–Sacks endocarditis and in recent months developed heart failure with progressive exertional dyspnoea from New York Heart Association (NYHA) functional Class from New York Heart Association (NYHA) functional class II to III. In addition, there was progressive left ventricular dilatation and reduction in left ventricular ejection fraction. In view of the high surgical risk, she underwent transcatheter edge-to-edge repair (TEER) of the mitral valve with the MitraClip system. At 1-month follow-up, she was back to NYHA functional Class II with mild MR. Discussion Our case demonstrates that in select patient with suitable anatomy, TEER is a potential treatment option for severe MR from SLE valvulopathy.
ISSN:2514-2119
2514-2119
DOI:10.1093/ehjcr/ytab361