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[Abdominal Apoplexy after Mitral Valve Replacement Due to Infective Endocarditis;Report of a Case]

Motoyuki Kumagai1, Makoto Takehara, Junichiro Nishizawa

  • 1Department of Cardiovascular Surgery, Hamamatsu Rosai Hospital, Hamamatsu, Japan.

Kyobu Geka. the Japanese Journal of Thoracic Surgery
|May 13, 2020
PubMed

Insights

A patient developed abdominal apoplexy after mechanical mitral valve replacement. Management involved careful anticoagulation control to prevent bleeding, leading to a favorable outcome.

Area of Science:

  • Cardiology
  • Vascular Surgery

Background:

  • Infective endocarditis can lead to mitral valve insufficiency and heart failure.
  • Mechanical valve replacement is a common treatment for severe valve dysfunction.

Observation:

  • A 52-year-old woman developed sudden anemia and abdominal pain on postoperative day 8 after mitral valve replacement.
  • Imaging suggested abdominal apoplexy, but active bleeding was not confirmed.

Findings:

  • The patient's anticoagulation, monitored by prothrombin time-international normalized ratio (PT-INR), was initially 2.56 on postoperative day 7, then 1.70 on postoperative day 8.
  • Therapeutic PT-INR was managed around 1.5 to prevent recurrent bleeding.

Implications:

  • This case highlights the importance of vigilant monitoring for rare complications like abdominal apoplexy post-mechanical valve replacement.
  • Careful anticoagulation management is crucial in patients with mechanical valves, especially when gastrointestinal complications arise.

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