tailieunhanh - Báo cáo y học: " Bioprosthetic mitral valve thrombosis less than one year after replacement and an ablative MAZE procedure: a case report"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Wertheim cung cấp cho các bạn kiến thức về ngành y đề tài: Bioprosthetic mitral valve thrombosis less than one year after replacement and an ablative MAZE procedure: a case report. | Saeed et al. Journal of Cardiothoracic Surgery 2010 5 18 http content 5 1 18 JOTS JOURNAL OF CARDIOTHORACIC SURGERY CASE REPORT Open Access Bioprosthetic mitral valve thrombosis less than one year after replacement and an ablative MAZE procedure a case report Omar Saeed1 Byron R Williams Jr2 Melvin Ku3 Omar M Lattouf4 Abstract Occurrence of bioprosthetic valve thrombosis less than a year after replacement is very uncommon. Here we describe a case of a 57 year old male who presented 10 months after receiving a bioprosthetic mitral valve replacement with a two week history of dyspnea on exertion worsening orthopnea and decreased exercise tolerance. Echocardiography revealed severe mitral regurgitation MR thrombosis of the posterior mitral leaflet left atrial LA mural thrombus and a depressed left ventricular ejection fraction of twenty-five percent. Given severe clot burden and decompensated heart failure New York Heart Association - NYHA class III repeat sternotomy was done to replace the bioprosthetic mitral valve and remove LA mural thrombus. MR was resolved postoperatively. This brief report further reviews promoting factors established guidelines and management strategies of bioprosthetic valve thrombosis. Background Bioprosthetic mitral valves are advantageous over mechanical valves as their incidence of thrombosis pannus formation and embolic events are significantly lower. This disparity in thromboembolic events as compared to mechanical valves avoids a need for chronic anticoagulation in many patients receiving bioprosthetic valve replacement 1 . However bioprosthetic mitral valves can present with thrombosis shortly after replacement in high risk patients not maintained on anticoagulation leading to severe valve incompetence and cardiac decompensation as noted in the following case. Case Presentation A 57 year old male with a past medical history of chronic atrial fibrillation a depressed ejection fraction of 25 and severe MR .