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Valve-shaped thrombus underneath an aortic bioprosthesis
Giorgia Cibin1, Augusto D'Onofrio1, Assunta Fabozzo1
1Division of Cardiac Surgery, University of Padova, Padua, Italy.
Journal of Cardiac Surgery
|July 26, 2021
Summary
Massive thrombus formation occluding an aortic bioprosthesis occurred in a patient on venoarterial extracorporeal membrane oxygenation (VA-ECMO) with apical venting. Surgical removal of the thrombus led to full patient recovery without complications.
Area of Science:
- Cardiovascular Surgery
- Medical Devices
- Extracorporeal Life Support
Background:
- Aortic bioprosthetic valves are crucial for treating aortic valve disease.
- Complications such as thrombosis can compromise valve function and patient outcomes.
- Venoarterial extracorporeal membrane oxygenation (VA-ECMO) with apical venting is a complex support system that may influence thrombotic events.
Purpose of the Study:
- To report a rare case of massive thrombus formation occluding an aortic bioprosthesis in a patient undergoing VA-ECMO with apical venting.
- To highlight the importance of prompt diagnosis and intervention for such critical complications.
Main Methods:
- A patient on VA-ECMO with apical venting developed acute aortic bioprosthesis occlusion.
- Diagnostic imaging confirmed massive thrombus formation.
- The patient underwent urgent surgical thrombectomy.
Main Results:
- The aortic bioprosthesis was completely occluded by a massive thrombus.
- Surgical removal of the thrombus was successful.
- The patient recovered without any immediate complications.
Conclusions:
- Massive thrombus formation can critically occlude aortic bioprostheses, even in patients on advanced circulatory support.
- Timely identification and surgical intervention are essential for successful management and patient recovery.
- This case underscores the potential risks associated with VA-ECMO and apical venting in relation to prosthetic valve thrombosis.
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