Reumatología Clínica (English Edition) Reumatología Clínica (English Edition)
Reumatol Clin 2018;14:269-77 - Vol. 14 Num.5 DOI: 10.1016/j.reumae.2017.01.016
Original Article
Cardiac Surgery in Systemic Lupus Erythematosus Patients: Clinical Characteristics and Outcomes
Cirugía cardiaca en pacientes con lupus eritematoso sistémico: características clínicas y desenlaces
Javier Tejeda-Maldonadoa, Lauro Quintanilla-Gonzáleza, Jaime Galindo-Uribeb, Andrea Hinojosa-Azaolac,,
a Departamento de Medicina Interna, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
b Departamento de Cardiología, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
c Departamento de Inmunología y Reumatología, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
Received 16 August 2016, Accepted 26 January 2017

To study the clinical characteristics and outcomes in systemic lupus erythematosus (SLE) patients who underwent cardiac surgery.


Retrospective analysis of 30 SLE patients who underwent cardiac surgery at a single center. Demographics, comorbidities, clinical and serologic characteristics, cardiovascular risk scores and treatment were recorded. Type of surgery, postoperative complications, mortality and histology were analyzed.


Disease duration at surgery was 2 years. Valve replacement was the procedure most frequently performed (53%), followed by pericardial window (37%). At least one postoperative complication developed in 63% (mainly infections). An aortic cross-clamp time ≥76min was associated with at least one postoperative complication (OR 6.4, 95% CI 1.1–35.4, P=.03). Early death occurred in 5 patients (17%) and late in 3 (10%); main causes were sepsis and heart failure. Disease activity was associated with pericardial window (OR 12.6, 95% CI 1.9–79, P=.007); lymphopenia1.200 (OR 10.1, 95% CI 1.05–97, P=.04); age30 years (OR 7.7, 95% CI 1.2–46.3, P=.02); and New York Heart Association class III (OR 7.0, 95% CI 1.1–42, P=.03). Postoperative infection was associated with length of hospital stay2 weeks (OR 54.9, 95% CI 5.0–602.1, P=.001); intensive care unit stay10 days (OR 20, 95% CI 1.6–171.7, P=.01); duration of mechanical ventilation ≥5 days (OR 16.9, 95% CI 1.5–171.7, P=.01); and pulmonary artery systolic pressure ≥50mmHg (OR 7.8, 95% CI 1.4–41.2, P=.01).


Cardiac surgery in SLE confers high morbidity and mortality. SLE-specific preoperative risk scores should be designed to identify prognostic factors.


Estudiar las características clínicas y desenlaces de los pacientes con lupus eritematoso sistémico (LES) intervenidos de cirugía cardiaca.


Se realizó un estudio retrospectivo de 30 pacientes con LES y cirugía cardiaca en un solo centro. Se registraron comorbilidades, características demográficas, clínicas, serológicas, riesgo cardiovascular, tratamiento, tipo de cirugía, complicaciones postoperatorias, mortalidad e histología.


La duración de LES al momento de la cirugía fue de 2 años. El procedimiento más frecuente fue recambio valvular (53%), seguido de ventana pericárdica (37%). Al menos una complicación postoperatoria se presentó en el 63% (principalmente infecciones). Un pinzamiento aórtico76min se asoció con al menos una complicación (OR 6,4; IC 95% 1,1–35,4, p=0,03). La mortalidad temprana ocurrió en 5 pacientes (17%) y tardía en 3 (10%); siendo las causas principales sepsis e insuficiencia cardiaca. La actividad de la enfermedad se asoció a la realización de ventana pericárdica (OR 12,6; IC 95% 1,9–79; p=0,007), presencia de linfopenia1.200 (OR 10,1; IC 95% 1,05–97; p=0,04), edad30 años (OR 7,7; IC 95% 1,2–46,3; p=0,02) y NYHA clase III (OR 7,0; IC 95% 1,1–42, p=0,03). El desarrollo de infección postoperatoria se asoció con estancia hospitalaria2 semanas (OR 54,9; IC 95% 5,0–6021; p=0,001), estancia en UCI10 días (OR 20; IC 95% 1,6–171,7, p=0,01), duración de ventilación mecánica ≥ 5 días (OR 16,9, IC 95% 1,5–171,7, p = 0,01) y PSAP50mmHg (OR 7,8; IC 95% 1,4–41,2; p=0,01).


La cirugía cardiaca en LES se asocia a alta morbimortalidad.

Systemic lupus erythematosus, Cardiac surgery, Valve replacement, Pericardial window
Palabras clave
Lupus eritematoso sistémico, Cirugía cardiaca, Recambio valvular, Ventana pericárdica


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Reumatol Clin 2018;14:269-77 - Vol. 14 Num.5 DOI: 10.1016/j.reumae.2017.01.016
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