Complete prosthetic valve thrombosis despite several thrombolytic treatments after tricuspid valve replacement

We discuss the case of a 50-year-old man who underwent tricuspid valve replacement with a mechanical prosthesis (Duromedics) due to traumatic tricuspid insufficiency following a blunt chest trauma fifteen years previously. Despite correct anticoagulation therapy several events of prosthetic valve thrombosis occurred in the following years. The patient was treated four times by thrombolytic therapy. Finally, seven years after the initial operation the mechanical valve was replaced by a Carpentier-Edwards bioprosthesis because of complete blockage.