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J Thorac Cardiovasc Surg 2008;136:215-216
© 2008 The American Association for Thoracic Surgery

Brief Communication

Surgical management of thoracoabdominal aortic aneurysm associated with systemic lupus erythematosus

^a Cardiothoracic Section, Anesthesiology and Critical Care, University of Pennsylvania School of Medicine, Philadelphia, Pa
^b Division of Vascular Surgery, Department of Surgery, University of Pennsylvania School of Medicine, Philadelphia, Pa
^c Division of Cardiothoracic Surgery, Department of Surgery, University of Pennsylvania School of Medicine, Philadelphia, Pa

Received for publication August 8, 2007; accepted for publication August 14, 2007.

^_* Address for reprints: John G. T. Augoustides, MD, FASE, Assistant Professor, Cardiothoracic Section, Anesthesiology and Critical Care, Dulles 680, HUP, 3400 Spruce St, Philadelphia, PA. (Email: yiandoc@hotmail.com).

The first 20% of the full text of this article appears below.

Systemic lupus erythematosus (SLE) is associated with aortitis that may cause aneurysm and/or dissection.^1-4 Furthermore, the aortic syndromes associated with SLE do not typically correlate with the degree of cardiac inflammation, especially with endocarditis.⁵ We present a case of thoracoabdominal aneurysm (TAA) associated with Libman-Sacks endocarditis in a patient with chronic SLE. To the best of our knowledge, this is the first report of this dual presentation in a surgical patient with SLE.

Clinical Summary

A 29-year-old woman with longstanding SLE had severe back pain. Her medical history included hypertension and hemodialysis for end-stage renal disease. Her physical examination was notable for severe hypertension and an apical holosystolic murmur. She had no fever or peripheral stigmata of endocarditis. A computerized tomographic axial scan revealed an extent V TAA with a maximal diameter of 6 cm ( Figure 1). She was admitted to the intensive care unit for aggressive intravenous vasodilator therapy. Myocardial perfusion imaging with . . . [Full Text of this Article]