[Unplanned Ascending Aortic Graft Replacement at Valvuler Surgery in a Patient with Systemic Lupus Erythematosus;Report of a Case]

Abstract

A 65-year-old woman with severe mitral stenosis was admitted to our hospital. She had been previously diagnosed with systemic lupus erythematosus (SLE) and had been taking prednisolone (5 mg/day) for 19 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 the risk of a dissection of the ascending aorta. However, hemostasis was difficult at the insertion point of the catheter to infuse the antegrade cardioplegic solution. An ascending aortic graft replacement was therefore performed. Histopathological examination of the aortic wall showed the presence of intimal hypertrophy and a decrease in elastic fiber content but without any evidence of vasculitis. Because prolonged steroids use is a risk factor of atherosclerotic change in the aortic wall, the aorta should be treated carefully during cardiovascular surgery in such patients.