scholarly journals A Rare Case of Partial Aortic Mechanical Valve Thrombosis With Intact Mitral Mechanical Valve Presenting With ST-Elevation Myocardial Infarction Patients

2020 ◽  
Vol 8 ◽  
pp. 232470962096356
Author(s):  
Mazin O. Khalid ◽  
Yury Malyshev ◽  
Arsalan Talib Hashmi ◽  
Sabah Siddiqui ◽  
NeelKumar Patel ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Mitral Valve ◽  
Aortic Valve ◽  
Anticoagulation Therapy ◽  
Mechanical Valve ◽  
Valve Prosthesis ◽  
Presenting Symptoms ◽  
Mechanical Aortic Valve ◽  
Valve Thrombosis ◽  
Aortic Valve Prosthesis

The incidence of mechanical valve thrombosis (MVT) is around 0.4 per 100 patient-years. Mitral valve thrombosis has a higher incidence than aortic valve thrombosis with a nearly 5-fold increase. Various factors contribute to MVT. The most common cause of valve thrombosis is poor adherence/disruption of anticoagulation therapy. Low cardiac output is known to increase the risk of prosthetic valve thrombosis. Other factors such as diabetes, hypertension, and other patient comorbidities might also play a role. Decreased flow promotes hypercoagulability. Lower pressure in the left atrium (and higher velocities in the left ventricle) can partially contribute to the higher incidence of mitral MVT versus aortic MVT. The presenting symptoms usually depend on the severity of the valve thrombosis; nonobstructive valve thrombosis patients have progressive dyspnea, signs of heart failure, and systemic embolization with strokes being the most common complication. In this article, we present a case of a middle-aged woman with a history of mitral and aortic mechanical prosthesis who presented with an ST-segment elevation myocardial infarction and pulmonary edema due to mechanical aortic valve prosthesis thrombosis. She had an isolated mechanical aortic valve prosthesis thrombosis with intact mitral valve, which, to the best of our knowledge, has not yet been described. We performed a literature review by searching PubMed and Embase using the keywords “mechanical valve,” “thrombosis,” “aortic,” and “mitral,” our search did not show similar cases.

scholarly journals Successful Use of Two Thrombolytic Drugs in Prosthetic Mitral and Aortic Valve Thrombosis

2020 ◽  
Author(s):  
Shayesteh Gheibi ◽  
Aliasghar Farsavian ◽  
Maryam Nabati ◽  
Gohar Eslami
Keyword(s):  
Mitral Valve ◽  
Aortic Valve ◽  
Anticoagulation Therapy ◽  
Mechanical Valve ◽  
Valve Prosthesis ◽  
Mechanical Prosthesis ◽  
First Line Therapy ◽  
Mitral Valve Prosthesis ◽  
Valve Thrombosis ◽  
Mobile Mass

Introduction: Prosthetic valve thrombosis is a rare and severe complication of valve replacement, most often encountered with a mechanical prosthesis. The significant morbidity and mortality associated with this condition warrant rapid diagnostic evaluation. Although surgery is the first-line therapy in symptomatic obstructive mechanical valve thrombosis, thrombolytic therapy has been used as an alternative. Case Description: In this case report, we describe a 46-year-old man with a history of the mitral valve and aortic valve replacement 2 years ago. In echocardiography, we detected a mobile mass on the atrial side of the mitral valve prosthesis and a fixed one on the leaflet of the mechanical aortic valve with a high gradient. To save his life, we used double thrombolytic therapy considering the patient’s hemodynamic situation and the risk of bleeding. Although a routine dose of reteplase and streptokinase was considered, we administered these two thrombolytic drugs together within 72 hours. Conclucsion: Ultimately we succeeded with this method without any significant or life-threatening adverse effects, and the patient was discharged after an optimal anticoagulation therapy.

Passing a Mechanical Aortic Valve With a Short Tip Dilator to Facilitate Aortic Arch Endovascular Branched Repair

2021 ◽  
pp. 152660282110025
Author(s):  
Nikolaos Konstantinou ◽  
Sven Peterss ◽  
Jan Stana ◽  
Barbara Rantner ◽  
Ramin Banafsche ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Arch ◽  
Stent Graft ◽  
Mechanical Valve ◽  
Valve Prosthesis ◽  
Proper Position ◽  
Mechanical Aortic Valve ◽  
Aortic Replacement ◽  
Custom Made ◽  
Aortic Valve Prosthesis

Purpose To present a novel technique to successfully cross a mechanical aortic valve prosthesis. Technique A 55-year-old female patient with genetically verified Marfan syndrome presented with a 5-cm anastomotic aneurysm of the proximal aortic arch after previous ascending aortic replacement due to a type A aortic dissection in 2007. The patient also underwent mechanical aortic valve replacement in 1991. A 3-stage hybrid repair was planned. The first 2 steps included debranching of the supra-aortic vessels. In the third procedure, a custom-made double branched endovascular stent-graft with a short 35-mm introducer tip was implanted. The mechanical valve was passed with the tip of the dilator on the lateral site of the leaflet, without destructing the valve and with only mild symptoms of aortic insufficiency, as one leaflet continued to work. This allowed the implantation of the stent-graft directly distally of the coronary arteries. Postoperative computed tomography angiography showed no endoleaks and patent coronary and supra-aortic vessels. Conclusion Passing a mechanical aortic valve prosthesis at the proper position is feasible and allows adequate endovascular treatment in complex arch anatomy. However, caution should be taken during positioning of the endovascular graft as the tip may potentially damage the valve prosthesis.

scholarly journals Retrograde Transcatheter Closure of Mitral Paravalvular Leak through a Mechanical Aortic Valve Prosthesis: 2 Successful Cases

2016 ◽  
Vol 43 (2) ◽  
pp. 137-141 ◽  
Author(s):  
Daxin Zhou ◽  
Wenzhi Pan ◽  
Lihua Guan ◽  
Juying Qian ◽  
Junbo Ge
Keyword(s):  
Aortic Valve ◽  
Transcatheter Closure ◽  
Mechanical Valve ◽  
Percutaneous Closure ◽  
Paravalvular Leak ◽  
Valve Prosthesis ◽  
Transseptal Puncture ◽  
Mechanical Aortic Valve ◽  
Hemodynamic Deterioration ◽  
Aortic Valve Prosthesis

The presence of a mechanical aortic valve prosthesis has been considered a contraindication to retrograde percutaneous closure of mitral paravalvular leaks, because passing a catheter through the mechanical aortic valve can affect the function of a mechanical valve and thereby lead to severe hemodynamic deterioration. We report what we believe are the first 2 cases of retrograde transcatheter closure of mitral paravalvular leaks through a mechanical aortic valve prosthesis without transseptal or transapical puncture. Our experience shows that retrograde transcatheter closure of mitral paravalvular leaks in this manner can be an optional approach for transcatheter closure of such leaks, especially when a transapical or transseptal puncture approach is not feasible. This technique might also be applied to other transcatheter procedures in which there is a need to pass a catheter through a mechanical aortic valve prosthesis.

Hemodynamic Evaluation of a Biological and Mechanical Aortic Valve Prosthesis Using Patient-Specific MRI-Based CFD

2017 ◽  
Vol 42 (1) ◽  
pp. 49-57 ◽  
Author(s):  
Florian Hellmeier ◽  
Sarah Nordmeyer ◽  
Pavlo Yevtushenko ◽  
Jan Bruening ◽  
Felix Berger ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Patient Specific ◽  
Valve Prosthesis ◽  
Hemodynamic Evaluation ◽  
Mechanical Aortic Valve ◽  
Aortic Valve Prosthesis

scholarly journals Acute Myocardial Infarction due to Coronary Artery Embolism in a Patient with Mechanical Aortic Valve Prosthesis

2010 ◽  
Vol 2010 ◽  
pp. 1-4 ◽  
Author(s):  
Marcelo A. Nakazone ◽  
Bruno G. Tavares ◽  
Maurício N. Machado ◽  
Lilia N. Maia
Keyword(s):  
Myocardial Infarction ◽  
Coronary Artery ◽  
Systolic Dysfunction ◽  
Anticoagulation Therapy ◽  
Coronary Intervention ◽  
Valve Prosthesis ◽  
Artery Embolism ◽  
Coronary Artery Embolism ◽  
Aortic Valve Prosthesis ◽  
Coronary Embolism

Previous cases of coronary embolism as a cause of myocardial infarction (MI) in association with prosthetic mechanical valves have been reported, but the fact that the patient was not aware of the importance of maintaining anticoagulation therapy is relevant in this case. A 16-year-old female was referred for primary coronary intervention due to subacute anterolateral ST elevation MI, after she decided to discontinue warfarin therapy three weeks before. Coronary angiography showed distal occlusion of the left anterior descending coronary artery with an image suggesting embolic material. Conventional echocardiography demonstrated akinesia of anteroseptal, inferior, and posterior segments of the left ventricle, with severe systolic dysfunction, beyond the intraventricular thrombus. The presence of mechanic aortic prosthesis and no anticoagulation therapy are highly suggestive of coronary embolism as the cause of MI. This case report confirms that patient education is vital in our struggle to prevent this complication in high-risk patients.

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