A CASE OF “BENIGN”, RECURRENT, BIOPROSTHETIC MITRAL VALVE THROMBOSIS
Abstract:
Current guidelines recommend three month of anticoagulation after implantation of a
bioprosthetic valve. However, there is an increasing concern, that biological valve thrombosis is more
frequent than previously thought, and is an important factor of increased morbidity and mortality. Our
case, an asymptomatic 67 years old lady with mitral bioprosthesis, presented an unusual form of
thrombosis: a serpent-like, membranous, hypermobile structure attached to the ventricular side of the
septal annulus, without provoking prosthesis malfunction. The mass proved to have a “benign” course:
disappeared after 3 days of anticoagulation without any sign of embolization. Being on an improper oral
vitamin K antagonist treatment (subtherapeutical INRs) the mass returned after 4 month, but had the
same “benign” course. Subsequently, a novel oral anticoagulant was chosen for antithrombotic therapy.
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