Patient with systemic lupus erythematosus gets successful aortic valve replacement

Mohali, October 10, 2023: A 57-year-old female patient with systemic lupus erythematosus (SLE), which is a challenging autoimmune condition, was treated successfully at Ivy Hospital recently.

Giving information, Dr. Virender Sarwal, director cardiothoracic and vascular surgery said that the patient underwent aortic valve replacement (AVR) with a mechanical valve for severe aortic stenosis.

SLE is an autoimmune disease where the immune system mistakenly attacks the body's own tissues, leading to extensive damage. Cardiac surgery in such cases is exceedingly rare and carries a high risk of mortality and morbidity, said Dr Sarwal.

According to the Society of Thoracic Surgeons' data, only 329 cases of cardiac surgery have been performed in SLE patients over the last 27 years in the USA, with just 164 of them involving valve surgeries.

Dr. Jagpal Pandher consultant internal medicine at IVY also played a crucial role in the successful outcome of the surgery. He meticulously investigated the patient preoperatively and provided valuable assistance during the postoperative period, considering the patient's steroid and HCQ medication, which suppress the immune system.
Dr Suresh K Goal pulmonologist assessed the patient's lung reserves, as SLE can adversely affect lung function. Their expertise ensured a comprehensive preoperative evaluation to minimize risks.

The surgery was performed with utmost precision, addressing the complexity of SLE patients, including the involvement of the pericardium, which often leads to dense adhesions that require meticulous dissection during surgery, said Dr Sarwal.

Furthermore, the patient required proper anticoagulation while on the heart-lung machine to prevent thromboembolic episodes and minimize infection risks.