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Title: Very late bioprosthetic aortic valve thrombosis.
Austin Authors: Balakrishnan, Kuhendra ;Herman, Brian;Koshy, George
Affiliation: School of Medicine, University of Tasmania, Launceston, Tasmania, Australia
Cardiology, Launceston General Hospital, Launceston, Tasmania, Australia
Issue Date: 8-May-2019
Date: 2019-05-08
Publication information: BMJ Case Reports 2019; 12(5): e228871
Abstract: A 79-year-old man with a history of bioprosthetic aortic valve (AV) replacement in 2008 and atrial fibrillation was admitted with acute pulmonary oedema. Transthoracic and transoesophageal echocardiograms revealed significantly elevated AV gradients and thickened AV leaflets. These findings were suggestive of bioprosthetic valve thrombosis (BVT). The patient was treated with intravenous heparin and commenced on vitamin K antagonist. BVT remains an under recognised cause of late prosthetic valve dysfunction. A lack of awareness of BVT occurring beyond 3 months post-implantation is likely to account for this. Furthermore, structural valve degeneration is the most common mechanism of late prosthetic valve dysfunction. Recognising the difference between the two aetiologies is crucial as the management plan differs significantly. Here, we report a case of very late bioprosthetic AV thrombosis diagnosed 8 years after implantation. This was successfully treated with systemic anticoagulation, thereby avoiding the need for redo cardiac surgery.
DOI: 10.1136/bcr-2018-228871
ORCID: 0000-0002-6481-8069
Journal: BMJ Case Reports
PubMed URL: 31068347
Type: Journal Article
Subjects: Heart failure
Valvar diseases
Appears in Collections:Journal articles

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