Horseshoe thrombus in a patient with mechanical prosthetic mitral valve: A case report and review of literature

Abstract

Patients with prosthetic cardiac valves are at high risk for thromboembolic complications and need life long anticoagulation with warfarin, which can be associated with variable dose requirements and fluctuating level of systemic anticoagulation and may predispose to thromboembolic and or hemorrhagic complications. Prosthetic cardiac valve thrombosis is associated with high morbidity and mortality. A high index of suspicion is essential for prompt diagnosis. Transthoracic echocardiography, and if required transesophageal echocardiography are the main diagnostic imaging modalities. Medically stable patients can be managed with thrombolytic therapy and anticoagulation, while some patients may require surgical thrombectomy or valve replacement. We present a case report of a patient with prosthetic mitral valve and an unusually large left atrial thrombus with both thromboembolic and hemorrhagic complications.

Contrast Tuned Imaging for Detection of Left Ventricular apical thrombus: A Case Report

“…Thrombi that projected into the ventricular cavity were classified as protruding and thrombi that did not were classified as flat. A thrombus has usually an echodensity similar to the myocardium while pannus appears more hyperechoic [17] .…”

A Rare Case of Multiple Myxoma Involving Both Mitral Valve Leaflets

“…8) Mitral valve thrombosis is a rare entity, and typically occurs after mitral valve replacement. 10) Postoperative thrombosis of mitral valve is a severe complication of mechanical valve replacement surgery. 10) The more active thrombosis with pedicle is very rare.…”

“…10) Postoperative thrombosis of mitral valve is a severe complication of mechanical valve replacement surgery. 10) The more active thrombosis with pedicle is very rare. 11) Most thrombi are less mobile, lack a pedicle, and the shape generally does not change during the cardiac cycle, which differentiates it from myxoma.…”

Fibrinolytic Treatment after Transient Ischaemic Attack Caused by Prosthetic Mitral Valve Thrombosis

“…Up to the 1990s, surgery was the preferred treatment in the case of thrombosis of prosthetic heart valves. Depending on the preoperative state of the patient, the mortality rate of surgical thrombectomy or valve replacement was approximately 69% [ 13 , 14 ].…”