Percutaneous management of recurrent prosthetic valve thrombosis

Abstract

CASE PRESENTATION Prosthetic valve thrombosis (PVT) is a complication associated with a high morbimortality rate. Yet despite anticoagulation, the rate of PVT is between 0.5% and 8%.1 The management of this disease depends on various factors like the size and location of the thrombus, the degree of valvular obstruction or dysfunction, the symptoms at presentation, and the patient’s hemodynamic status. Therapeutic options include surgery and fibrinolysis. Both have given good results, but they are not always effective and are associated with a high risk of complications. This is the case of a 55-year-old woman with rheumatic myocardiopathy treated with aortic and mitral valve replacement using the bidisco ATS 27 mechanical heart valve (Medtronic ATS Medical, Inc, Plymouth, Minnesota, United States) and Sorin Overline 29 device (Sorin Biomedica Cardio SpA, Saluggia, Italy), respectively. The patient granted consent to publish her case, respecting her right to privacy and the protection of personal data. Two months after surgery the patient was showing signs of dyspnea (New York Heart Association functional class III) and she was diagnosed with obstructive thrombosis of the prosthetic mitral valve. The transesophageal echocardiography (TEE) performed revealed the presence of a mass compatible with a thrombus attached to the atrial side of...