Successful thrombectomy of a stuck mechanical prosthetic mitral valve guided by perioperative transesophageal echocardiography and cinefluoroscopy

We describe the case of a 53-year-old man with past history of rheumatic valvular disease who developed acute decompensated heart failure due to thrombosis of his mechanical mitral valve prosthesis. The diagnosis was established after a combined and complementary approach of echocardiography and cin...

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Bibliographic Details
Published inEinstein (São Paulo, Brazil) Vol. 7; no. 1; pp. 99 - 102
Main Authors Paulo César Gobert Damasceno Campos, Marcelo Luiz Vieira, Ivan D’Cruz, Darryl Weiman
Format Journal Article
LanguageEnglish
Published Instituto Israelita de Ensino e Pesquisa Albert Einstein 01.03.2009
Subjects
Echocardiography
Fluoroscopy
Heart valve prosthesis
Thrombectomy
Thrombosis
transesophageal
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Summary:We describe the case of a 53-year-old man with past history of rheumatic valvular disease who developed acute decompensated heart failure due to thrombosis of his mechanical mitral valve prosthesis. The diagnosis was established after a combined and complementary approach of echocardiography and cinefluoroscopy. Because of the severe heart failure at presentation, the patient was taken to surgery. The intraoperative transesophageal echocardiography was critical to guide a successful thrombectomy procedure. Postoperative pathological findings revealed the presence of thrombus and fibrotic tissue (pannus) in the surgical specimens removed from the valve. The success of this case and the treatment choice are supported by the most recent literature data on prosthetic valve thrombosis. We highlight the use of three diagnostic approaches in our patient: echocardiography, cinefluoroscopy and pathology.
ISSN:1679-4508