Unexpected mechanical bileaflet valve thrombosis in mitral position: what is better to do, re-replacement or thrombolysis

Langenbecks Arch Surg. 2002 Jul;387(3-4):166-9. doi: 10.1007/s00423-002-0302-1. Epub 2002 Jul 16.

Abstract

Background and aims: The longevity of the mechanical heart valve prosthesis is an advantage when compared with its biological counterpart, although the former carries a risk of thrombosis depending on valve design, materials and host-related interface; therefore, a patient with a mechanical valve prosthesis, particularly in mitral position, is at risk for systemic thromboembolism even when properly anticoagulated.

Patients and methods: We report a case of a 60-year-old woman who underwent a mitral valve replacement with a St. Jude Medical (SJM) standard bileaflet mechanical heart valve.

Results: On the twelfth post-operative day a primary thrombosis with blockage of the anterior valve leaflet occurred.

Conclusions: Aware of the risk of recurrent thromboembolism in this special clinical framework and possible cerebral bleeding in case of thrombolysis, we replaced the prosthesis with a new biologic porcine valve, the SJM Biocor.

Publication types

  • Case Reports

MeSH terms

  • Acute Disease
  • Bioprosthesis
  • Echocardiography
  • Female
  • Heart Valve Prosthesis Implantation / adverse effects*
  • Humans
  • Middle Aged
  • Mitral Valve Stenosis / etiology
  • Mitral Valve Stenosis / surgery*
  • Patient Selection*
  • Recurrence
  • Reoperation*
  • Rheumatic Heart Disease / complications
  • Risk Factors
  • Thrombolytic Therapy*
  • Thrombosis / diagnosis
  • Thrombosis / etiology*
  • Thrombosis / therapy*