An uncommon case of bioprosthetic mitral valve thrombosis with subsequent prosthesis dehiscence

Bioprosthetic valve thrombosis (BVT) is uncommon. An 82-year-old gentleman presented following a cardioembolic stroke due to a mitral valve infective endocarditis. The patient underwent bioprosthetic mitral valve replacement. Following discharge, he re-presented with weakness due to a new left-sided stroke and right-sided occipital intracerebral haemorrhage. Both transthoracic and transoesophageal echocardiography revealed BVT on the anterior portion of the prosthesis. Following a multidisciplinary team discussion, it was felt that thrombolytics and anticoagulation would be detrimental. The patient continued to worsen and eventually succumbed to congestive cardiac failure. BVT is uncommon, and patients often present with signs and symptoms of heart failure, shock or embolism. There are no guidelines available on managing BVT in patients with concurrent intracerebral haemorrhage, highlighting the importance of multidisciplinary efforts and patient inclusivity in decision making.

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An Uncommon Case of Bioprosthetic Mitral Valve Thrombosis Complicated by Intracerebral Haemorrhage

Cardiovascular Imaging Asia ◽

10.22468/cvia.2021.00059 ◽

2021 ◽

Vol 5 (2) ◽

pp. 47

Author(s):

Raja Ezman Raja Shariff ◽

Rizmy Najme Khir ◽

Hafisyatul Aiza Zainal Abidin ◽

Sazzli Kasim

Keyword(s):

Mitral Valve ◽

Intracerebral Haemorrhage ◽

Valve Thrombosis ◽

Uncommon Case ◽

Bioprosthetic Mitral Valve

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A Case of Acute Massive Bioprosthetic Mitral Valve Thrombosis Leading to Fulminant Heart Failure

Case Reports in Cardiology ◽

10.1155/2020/7842591 ◽

2020 ◽

Vol 2020 ◽

pp. 1-3

Author(s):

Zeid Nesheiwat ◽

Pinang Shastri ◽

Rohit Vyas ◽

Cameron Burmeister ◽

Robert Grande ◽

...

Keyword(s):

Heart Failure ◽

Mitral Valve ◽

Bioprosthetic Valve ◽

Diagnosis And Management ◽

Valve Thrombosis ◽

Bioprosthetic Mitral Valve

Bioprosthetic valve thrombosis has been considered to be extremely unlikely, typically freeing patients from the potential complications of long-term anticoagulation. However, there have been several documented cases of bioprosthetic valve thrombosis and there are concerns that its incidence may be underreported. Experience with diagnosis and management of this condition is limited. Here, we present a case of acute massive bioprosthetic mitral thrombosis manifesting as fulminant heart failure.

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Bioprosthetic Mitral Valve Thrombosis

JACC Cardiovascular Imaging ◽

10.1016/j.jcmg.2021.08.023 ◽

2021 ◽

Author(s):

Gabriel Châteauneuf ◽

Hugo De Larochellière ◽

Marie-Annick Clavel ◽

Dimitri Kalavrouziotis ◽

Eric Charbonneau ◽

...

Keyword(s):

Mitral Valve ◽

Valve Thrombosis ◽

Bioprosthetic Mitral Valve

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Management of Valvular Heart Failure Due To Mechanical Mitral Valve Thrombosis During Pregnancy

Journal of Cardiac Failure ◽

10.1016/j.cardfail.2020.09.174 ◽

2020 ◽

Vol 26 (10) ◽

pp. S59

Author(s):

Hussain Almusawi ◽

Adrian daSilva-deAbreu ◽

David Elizardi ◽

Thomas Young

Keyword(s):

Heart Failure ◽

Mitral Valve ◽

Valve Thrombosis

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Diagnostic assessment of prosthetic mitral valve thrombosis by real-time three-dimensional transoesophageal echocardiography and successful thrombolytic treatment

CardioVascular Journal of Africa ◽

10.5830/cvja-2010-071 ◽

2011 ◽

Vol 22 (6) ◽

pp. 340-342 ◽

Cited By ~ 1

Author(s):

Humberto Morais ◽

Telmo Martins ◽

Jose Roberto ◽

Fidel Caceres-Loriga

Keyword(s):

Mitral Valve ◽

Real Time ◽

Three Dimensional ◽

Transoesophageal Echocardiography ◽

Diagnostic Assessment ◽

Thrombolytic Treatment ◽

Valve Thrombosis ◽

Prosthetic Mitral Valve

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Bioprosthetic mitral valve thrombosis: complete resolution by anticoagulation

Acta Cardiologica ◽

10.1080/00015385.2017.1351235 ◽

2017 ◽

Vol 73 (2) ◽

pp. 181-182 ◽

Cited By ~ 1

Author(s):

Camille Binda ◽

Edouard Hubert ◽

Pierre-Vladimir Ennezat ◽

André Vincentelli ◽

Sylvestre Marechaux

Keyword(s):

Mitral Valve ◽

Complete Resolution ◽

Valve Thrombosis ◽

Bioprosthetic Mitral Valve

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Bioprosthetic mitral valve thrombosis not prevented by novel oral anticoagulant and successfully treated with heparin

Cardiovascular Medicine ◽

10.4414/cvm.2020.02114 ◽

2020 ◽

Author(s):

Lixi Caspary ◽

Gino Lee ◽

Sonja Matter-Ensner ◽

Omer Dzemali ◽

Alain M. Bernheim

Keyword(s):

Mitral Valve ◽

Oral Anticoagulant ◽

Novel Oral Anticoagulant ◽

Valve Thrombosis ◽

Bioprosthetic Mitral Valve

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Utilization of intra-aortic balloon pump to allow MitraClip procedure in patients with non-coapting mitral valve leaflets: a case series

European Heart Journal - Case Reports ◽

10.1093/ehjcr/ytz045 ◽

2019 ◽

Vol 3 (2) ◽

Cited By ~ 2

Author(s):

Ran Eliaz ◽

Anna Turyan ◽

Ronen Beeri ◽

Mony Shuvy

Keyword(s):

Heart Failure ◽

Mitral Valve ◽

Multiorgan Failure ◽

Case Series ◽

Transoesophageal Echocardiography ◽

Posterior Wall ◽

Left Ventricular ◽

Left Ventricular Remodelling ◽

Intra Aortic Balloon Pump ◽

Annular Dilatation

Abstract Background The MitraClip (MC) procedure was designed for high-risk surgical patients with severe mitral regurgitation (MR). Some patients do not meet the required anatomical criteria due to advanced left ventricular remodelling and mitral annular dilatation leading to leaflet tethering and insufficient coaptation surface. Theoretically, ‘temporary remodelling’ of the mitral valve apparatus by pharmacological and/or mechanical support using intra-aortic balloon pump (IABP) could improve leaflets coaptation. Case summary We report a case series of four patients with severe MR and non-coapting leaflets who underwent MC implantation. Sufficient coaptation was achieved only after insertion of IABP. The first patient presented with worsening heart failure and severe MR after a non-reperfused posterior wall myocardial infarction (MI), underwent a successful procedure with good results. The second patient presented with worsening heart failure secondary to rheumatic MR, and underwent MC procedure with good results after the insertion of IABP. The third patient developed worsening heart failure and severe MR 2 months after an acute inferior-lateral MI, and underwent a successful procedure. The fourth patient presented with respiratory failure, the patient underwent the procedure, but unfortunately died a few days following the procedure from multiorgan failure. In each case, the insertion of the IABP decreased annular mitral diameter and increased the coaptation surface as assessed by transoesophageal echocardiography. Discussion For patients suffering from symptomatic severe MR who are not suitable candidates for MC procedure, IABP system enabled us to overcome mitral leaflet gap and complete the MC procedure successfully.

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