Pulmonary Embolism Post-Bioprosthetic Aortic Valve Replacement: A Case Report

Pulmonary embolism is a rare complication post-bioprosthetic valve replacement, which is seldom reported in the literature.

A 76-year-old woman was admitted to our institution with a diagnosis of pulmonary embolism, occurring 14 days after undergoing a second bioprosthetic valve replacement, which had been performed due to failure of the initial prosthesis. Postoperatively, the patient had been managed with aspirin monotherapy for the prevention of thromboembolic events. Transthoracic echocardiography demonstrated normal age-related diastolic function, a left ventricular ejection fraction of 59%, no evidence of bioprosthetic valve stenosis, and overall satisfactory prosthetic valve function. The patient was discharged on the eighth hospital day with the initiation of warfarin therapy.

It is crucial to closely monitor for clinical signs and symptoms of thromboembolism, such as pulmonary embolism, following bioprosthetic valve implantation, particularly in patients with high-risk factors including advanced age, female sex, hypertension, and a history of previous valve implantation failure. In such cases, clinicians should also consider intensifying antiplatelet or anticoagulation therapy beyond standard daily low-dose aspirin.