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Unexpected mechanical bileaflet valve thrombosis in mitral position: what is better to do, re-replacement or
1Department of Cardiovascular Surgery "V.Gallucci", University of Padua, Medical School, Via Giustiniani, 2, 35128 Padova, Italy. tomaso.bottio@unipd.it
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.