Postoperative prosthetic mitral valve occlusion due to left atrial thrombus during veno-arterial extracorporeal membrane oxygenation: a case report.
JA Clin Rep
; 8(1): 93, 2022 Dec 06.
Article
in En
| MEDLINE
| ID: mdl-36471130
ABSTRACT
BACKGROUND:
Anticoagulation using heparin is generally used to prevent thrombus formation during mechanical circulatory support, such as veno-arterial extracorporeal membrane oxygenation (VA-ECMO). However, during the early period following cardiac surgery, anticoagulation becomes more difficult due to the greater risk of critical bleeding complications. CASE PRESENTATION A 71-year-old man presented with acute prosthetic valve occlusion caused by left atrial thrombus formation and bioprosthetic valve thrombosis during peripheral VA-ECMO following mitral valve replacement (MVR) despite continuous heparin administration and loading of antiplatelet agents. The VA-ECMO flow rate decreased 10 h after the intensive care unit (ICU) admission after MVR. Exploratory transesophageal echocardiography (TEE) examination revealed a left atrial thrombus, prosthetic valve obstruction by the thrombus, and an intrapericardial hematoma.CONCLUSIONS:
Intracardiac thrombus formation might occur during VA-ECMO despite appropriate anticoagulation and loading of antiplatelet agents. Exploratory TEE examination was helpful in the detection of intra-atrial thrombus formation after cardiac surgery and surgical decision-making.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Language:
En
Journal:
JA Clin Rep
Year:
2022
Document type:
Article
Affiliation country:
Japan
Country of publication:
ALEMANHA
/
ALEMANIA
/
DE
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DEUSTCHLAND
/
GERMANY