Thrombosis of a Mechanical Mitral Valve Prosthesis
Patient A.N.S.H., 43 years old, female, married, brown, born and raised in the North-CE region, with a medical history of hypertension, rheumatic fever, and a mechanical mitral valve prosthesis for 7 years, with continuous oral anticoagulation therapy since the prosthesis, has been asymptomatic during the clinical follow-up.
However, she noticed that she recently started to present hypermenorrhea, looking for her gynecologist, from whom she was diagnosed with uterine myoma, with a hysterectomy indication. Shortly after, she was admitted in the local hospital for the gynecological surgery, when she was advised to discontinue oral anticoagulation, evolving on the 4th day with a severe cardiac insufficiency (NYHA IV), requiring cardiologic emergency assistance.
Her exams have shown anemia, acute renal injury, and alterations of coagulation panel. Due to her critical state, she was sent to ICU, where she initiated the appropriate therapy and performed a colorful Doppler echocardiography, which indicated the presence of a metallic prosthesis in the mitral position with significant dysfunction. In addition, it showed a greatly reduced mobility of their brochures, suggesting a thrombosis of the prosthesis.
Within an urgency character, the patient was sent to the surgical center, where, after other preoperative exams were done, she had her thrombosed mechanical prosthesis replaced with success for a bioprosthesis, about 17 h after her arrival at the Cardiology Hospital.
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