Novel Management for Stuck Mechanical Aortic Valve Leaflet Following Bentall With Bovine Aortic Arch

Mechanical heart valves offer long-term durability but carry a risk of thrombosis, even with therapeutic anticoagulation.

We present a case of a patient with a history of Bentall procedure and bovine aortic arch who developed a thrombotic stuck mechanical aortic valve. Despite therapeutic international normalized ratio and administration of thrombolytics, the obstruction persisted. Given the patient's high surgical risk, a novel percutaneous interventional approach was used, resulting in restoration of valve function and a favorable clinical outcome.

Mechanical valve thrombosis is a rare but life-threatening condition with an incidence of 0.1% to 5.7%. Although subtherapeutic international normalized ratio is a common cause, cases may occur despite adequate anticoagulation. This report highlights an innovative, catheter-based management strategy in a complex anatomical setting, emphasizing the need for alternative therapies in nonsurgical candidates.

Mechanical valve thrombosis can occur even with optimal anticoagulation. Novel interventional solutions may be lifesaving in select high-risk patients.