Mechanical prosthetic valve thrombosis

CARDIOVASCULAR IMAGE

Mechanical prosthetic valve thrombosis

Márcio Silva Miguel Lima; Marcelo Luiz Campos Vieira

Instituto do Coração (Incor) – HCFMUSP

^{Mailing address}

Key words: Thrombosis; Heart Valve Prosthesis; Blood Coagulation.

A 51-year-old female patient with a double-disk mechanical mitral valve prosthesis for one year had a history of inadequate use of anticoagulation therapy and developed progressive dyspnea. On admission to the emergency room of InCor, Sao Paulo, she presented respiratory distress, tachypnea, BP of 80/40 mmHg, jugular venous distension and pulmonary crackles. Transesophageal echocardiography was performed one hour after admission, and showed a large thrombus adhered to the mechanical prosthesis with restriction to disk motion; reduced prosthetic valve area (VA = 0.6 cm²); increased gradients (peak gradient of 38 mmHg and mean gradient of 26 mmHg); and moderate paraprosthetic leak. Emergency surgery was indicated; however, the patient died immediately before the procedure due to cardiovascular collapse.

Manuscript received October 07, 2008; revised manuscript received February 06, 2009; accepted May 15, 2009

Publication Dates

• Publication in this collection
  22 Oct 2009
• Date of issue
  Sept 2009