Document Detail

Early massive thrombosis of a mechanical mitral valve.
MedLine Citation:
PMID:  9885108     Owner:  NLM     Status:  MEDLINE    
We report the case of a 74-year-old woman who underwent an elective procedure to replace her mitral valve with a 27-mm CarboMedics bileaflet valve (CarboMedics, Inc.; Austin, Tex) to correct mitral incompetence. Massive thrombosis of the prosthesis was clinically evident on the 6th postoperative day, despite administration of warfarin therapy according to our usual protocol. After an unsuccessful attempt at thrombolysis with recombinant tissue plasminogen activator, the mechanical prosthesis was replaced with a bioprosthesis. The cause of the thrombosis is unknown, but transient suboptimal anticoagulation is assumed to be responsible. Although very early massive valve thrombosis is a rare occurrence, it is a known risk of prosthetic valve implantation. Antiplatelet therapy, in addition to the usual warfarin anticoagulation, can help to prevent it. If thrombosis is diagnosed, it can be managed by thrombolysis or, when thrombolysis is unsuccessful, by reoperation. Transesophageal echocardiography is fundamental in the diagnosis and management of this sequela.
P Masiello; G Mastrogiovanni; G Santoro; S Iesu; G Di Benedetto
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Texas Heart Institute journal / from the Texas Heart Institute of St. Luke's Episcopal Hospital, Texas Children's Hospital     Volume:  25     ISSN:  0730-2347     ISO Abbreviation:  Tex Heart Inst J     Publication Date:  1998  
Date Detail:
Created Date:  1999-03-12     Completed Date:  1999-03-12     Revised Date:  2009-11-18    
Medline Journal Info:
Nlm Unique ID:  8214622     Medline TA:  Tex Heart Inst J     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  303-5     Citation Subset:  IM    
Division of Cardiac Surgery, S. Giovanni di Dio e Ruggi D'Aragona Hospital, Salerno, Italy.
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MeSH Terms
Anticoagulants / therapeutic use
Coronary Thrombosis / etiology*
Heart Valve Prosthesis Implantation*
Mitral Valve Insufficiency / surgery*
Postoperative Complications*
Warfarin / therapeutic use
Reg. No./Substance:
0/Anticoagulants; 81-81-2/Warfarin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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