[Recurrent thromboses of the Björk-Shiley valve in a patient with gout]

A 56-year-old male, who had mitral stenosis and gout, underwent mitral valve replacement with the Björk-Shiley valve prosthesis. Four years after the surgery, the patient suddenly became dyspneic on exercise due to malfunctioning valve. Thrombosis was found on the prosthesis, which was replaced again by Björk-Shiley valve. Thrombotest value had been satisfactorily controlled at 12.8 +/- 4.2% with warfarin since the first surgery. Dilazep chlorate also had been prescribed. Hyperuricemia had been controlled with allopurinol. In spite of these combined medical therapy, thrombosed valve recurred. Clotted prosthesis was superseded by Carpentier-Edwards Bioprosthesis. Enhancement of platelet function of the patients with gout and hyperuricemia has been reported. Gout in this case might have influence on the recurrent episodes of thrombosis. Monitoring of platelet function would be necessary in follow-up of a patients with gout and valve replacement.