Disfunção aguda devido a uma trombose da prótese da válvula mitral mecânica

Abstract

An 64-year-old man received a 31-mm CarboMedics mechanical prosthesis for severe mitral regurgitation. After four days the patient presented fatigue and dyspnoea with rest; transthoracic and transesophageal Doppler echocardiographic study confirmed a failing mobility of prosthetic valve leaflet from thrombosis and an emergency operation was done. The postoperative course was uneventful. This is an unusual case of acute dysfunction from thrombosis of a mechanical mitral valve prosthesis in a patient on oral anticoagulant therapy and calciheparin. Descriptors: Thrombosis. Echocardiography. Mitral valve replacement Resumo Um homem de 64 anos recebeu uma prótese mecânica CarboMedics de 31 mm para refluxo mitral grave. Após quatro dias, o paciente apresentou-se com fadiga e dispnéia em repouso. Estudos do Doppler ecocardiografia transtorácica e transesofágica confirmaram uma disfunção na mobilidade do folheto da válvula protética devido à trombose e uma operação de emergência foi feita. O pós-operatório transcorreu sem intercorrências. Este é um caso incomum de disfunção grave devido à trombose de uma prótese mitral mecânica em um paciente tomando anticoagulantes orais e calciparina. Descritores: Trombose. Ecocardiografia. Troca da válvula mitral Disfunção aguda devido a uma trombose da prótese da válvula mitral mecânica Acute dysfunction from thrombosis of a mechanical mitral valve prosthesis

Aortic Dissection: An Easily Missed Diagnosis when Pain Doesn’t Hold the Stage

“…Another possible mechanism could be cardioembolism, originating from a thrombus obstructing the prosthetic metallic valve. Thromboembolism is the most common complication of mechanical valves; however, left atrium enlargement and atrial fibrillation could increase the risk of cardioembolism, even in patients on the correct anticoagulation treatment [13]. The AD was a surprising finding taking into account the absence of pain, and the fact that AD after aortic valve replacement is a rare complication [14,15], occurring in only about 1% of cases [15].…”