Reoperation for prosthetic thrombosis and acute neurologic injury

Open-heart surgery in patients with recent cardiogenic embolic stroke represents a difficult management problem. We present a patient who developed thrombosis of a mitral tilting-disc prosthesis complicated by repeat cerebral embolic episodes that resulted in acute neurologic injury. We believe that in such patients the indication for reoperation must be individually evaluated but it is justified in young subjects, even in the presence of severe neurologic damage.