Mechanical Mitral Valve Thrombosis in a Patient With Prior Nonbacterial Thrombotic Endocarditis

Kalyan R Chitturi; Miguel A Castro; Eric Salazar; Michael Deavers; Su Min Chang; John J Mahmarian; Karla M Kurrelmeyer

doi:10.1016/j.jaccas.2020.01.029

Mechanical Mitral Valve Thrombosis in a Patient With Prior Nonbacterial Thrombotic Endocarditis

JACC Case Rep. 2020 Apr 15;2(4):539-543. doi: 10.1016/j.jaccas.2020.01.029. eCollection 2020 Apr.

Authors

Kalyan R Chitturi¹, Miguel A Castro¹, Eric Salazar¹, Michael Deavers¹, Su Min Chang¹, John J Mahmarian¹, Karla M Kurrelmeyer¹

Affiliation

¹ Houston Methodist DeBakey Heart & Vascular Institute, Houston Methodist, Houston, Texas.

Abstract

A 54-year-old woman with a mechanical mitral valve replacement presented with recurrent admissions for pneumonia and pulmonary edema. Multimodality imaging revealed mobile masses on the prosthesis and discrepant point of care and inpatient international normalized ratio levels owing to antiphospholipid antibody cross-reactivity on the outpatient assay. The prosthetic valve thromboses resolved with therapeutic anticoagulation. (Level of Difficulty: Beginner.).

Keywords: APS, antiphospholipid syndrome; HIT, heparin-induced thrombocytopenia; INR, international normalized ratio; MHV, mechanical heart valve; MV, mitral valve; NBTE, nonbacterial thrombotic endocarditis; POC, point of care; PT, prothrombin time; PVT, prosthetic valve thrombosis; TEE, transesophageal echocardiography; antiphospholipid syndrome; antithrombotic therapies; mitral valve disease; nonbacterial thrombotic endocarditis; prosthetic valve thrombosis.

Publication types

Case Reports