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Prosthetic Mechanical Aortic Valve Thrombosis

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1 Credit CME

A man in his 60s with a history of metastatic prostate carcinoma, calcified bicuspid aortic stenosis, and aortic valve replacement 17 years ago presented to the emergency department with increasing shortness of breath. An outpatient cardiac electrocardiogram-gated computed tomography (CT) showed normal coronary arteries with a small, irregular perivalvular mass at the leaflet hinge point and reduced leaflet mobility, suggestive of obstructive valve thrombosis (Figure, A). Acute thrombolytic therapy was administered without any complications. Follow-up cardiac CT 3 days later showed normal leaflet motion and resolution of the thrombus (Figure, B). The patient was discharged with an adjusted anticoagulation regimen.

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CME Disclosure Statement: Unless noted, all individuals in control of content reported no relevant financial relationships. If applicable, all relevant financial relationships have been mitigated.

Article Information

Corresponding Author: Joao Boavida, MD, Department of Diagnostic Imaging and Intervention, Akershus University Hospital, Postboks 1000, Lørenskog 1478, Norway (joaoppboavida@gmail.com).

Conflict of Interest Disclosures: None reported.

References
1.
Dangas  GD , Weitz  JI , Giustino  G , Makkar  R , Mehran  R .  Prosthetic heart valve thrombosis.   J Am Coll Cardiol. 2016;68(24):2670-2689. doi:10.1016/j.jacc.2016.09.958PubMedGoogle ScholarCrossref
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Lim  WY , Lloyd  G , Bhattacharyya  S .  Mechanical and surgical bioprosthetic valve thrombosis.   Heart. 2017;103(24):1934-1941.PubMedGoogle Scholar
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Huang  F , Lan  Y , Cheng  Z , Zhang  Z , Ren  F .  Thrombolytic treatment of prosthetic valve thrombosis: a study using urokinase.   J Cardiothorac Surg. 2020;15(1):286. doi:10.1186/s13019-020-01324-7PubMedGoogle ScholarCrossref
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