Minimally invasive concomitant aortic and mitral valve surgery in systemic lupus erythematosus patients: a step ahead of our learning curve, challenges, and outcomes

Abstract

Introduction: Minimally invasive cardiac surgery (MICS) has emerged as a promising approach for treating valve disorders, offering reduced surgical trauma and faster recovery.

Case illustration: This case report details MICS in concomitant aortic and mitral valve surgery in a 37-year-old female patient presenting with severe aortic regurgitation (AR) and moderate mitral regurgitation (MR), complicated by systemic lupus erythematosus (SLE). The patient underwent minimally invasive double valve surgery involving aortic valve replacement and mitral valve repair. Despite careful preoperative planning and intraoperative transesophageal echocardiography (TEE) confirmation, postoperative challenges arose, including left leg weakness attributable to SLE-associated neuropathy. This report highlights the procedural nuances, pitfalls encountered, and how the surgical team navigated the steep learning curve associated with adopting the operative technique. Outcome evaluation revealed satisfactory mechanical valve function with no paravalvular leakage or residual MR. However, the case underscores the importance of anticipating complications, particularly in patients with complex comorbidities.

Conclusion: This report contributes to the growing body of literature on MICS, emphasizing the need for continuous refinement of techniques and a multidisciplinary approach to optimize patient outcomes.