Severe aortic insufficiency due to a huge leaflet perforation in Libman-Sacks syndrome: report of a case.

A 40-year-old woman who was diagnosed to have systemic lupus erythematosus developed complications of cerebral infarction and alveolar hemorrhage. Close examination revealed severe aortic insufficiency, and she was diagnosed with Libman-Sacks syndrome. Due to progressive dilatation of the left ventricle and her easily fatigued state, surgery was performed. On pathological examination, holes of 4-mm and 5-mm diameter were detected in the left coronary and noncoronary cusps of the aortic valve, respectively. The morphology of the valve lesions showed a characteristic shape of such huge holes.