International Journal of the Cardiovascular Academy

CASE REPORT
Year
: 2019  |  Volume : 5  |  Issue : 2  |  Page : 71--73

Large thrombus on a prosthetic aortic valve diagnosed on the 1st postpartum day


Sinan Varol1, Sevgi Özcan2, Gökmen Kum1, İrfan Şahin1, Ertuğrul Okuyan1 
1 Department of Cardiology, Bagcilar Training and Research Hospital, Health Sciences University, Istanbul, Turkey
2 Department of Cardiology, Okmeydani Training and Research Hospital, Health Sciences University, Istanbul, Turkey

Correspondence Address:
Dr. Sinan Varol
Department of Cardiology, Bagcilar Training and Research Hospital, Health Sciences University, Istanbul
Turkey

40 years old female with prosthesis aortic valve had developed shortness of breath and consulted to our clinic on the first postpartum day. Her dyspnea was worsened at the last week. She had a history of Bentall operation before 16 years ago, and had a bi-leaflet mechanical prosthetic valve. After detection of pregnancy, her warfarin treatment had switched to enoxaparine 6000 IU subcutaneously for twice a day, continued throughout the pregnancy. Her weight was 62 kg. She did not have any blood test for factor Xa. On physical examination, she has orthopnea, tachypnea (24/min), tachycardia (128 bpm) and hypotension (85/55 mmHg). Electrocardiogram was uneventful with sinus tachycardia of 128 bpm with normal axis. Echocardiography revealed normal left ventricle size with left ventricle hypertrophy, ejection fraction of 60%, reduced motion of prosthetic-valve leaflets and an obstructing mass between the struts. Doppler ultrasonography showed that prosthetic aortic valve has a pressure gradient of 104/59 mmHg. These findings were consistent with prosthetic thrombosis. Moderate aortic regurgitation into the left ventricle was also detected. Transesophageal echocardiography showed 1.4 × 2.3 cm thrombotic material located over leaflets and adjacent to the posterior aortic wall. It was restricting the valve motion. The patient underwent emergency operation immediately. The thrombotic material over mechanical valve was extracted and there was no pathology seen on mechanical valve, graft repaired primarily. Postoperative recovery was fine. No bacteria were detected both direct microscopy and culture.


How to cite this article:
Varol S, Özcan S, Kum G, Şahin &, Okuyan E. Large thrombus on a prosthetic aortic valve diagnosed on the 1st postpartum day.Int J Cardiovasc Acad 2019;5:71-73


How to cite this URL:
Varol S, Özcan S, Kum G, Şahin &, Okuyan E. Large thrombus on a prosthetic aortic valve diagnosed on the 1st postpartum day. Int J Cardiovasc Acad [serial online] 2019 [cited 2020 Jul 11 ];5:71-73
Available from: http://www.ijcva.com/article.asp?issn=2405-8181;year=2019;volume=5;issue=2;spage=71;epage=73;aulast=Varol;type=0