A Case of Acute Mechanical Mitral Valve Thrombosis Management With Venoarterial Extracorporeal Membrane Oxygenation

Mechanical prosthetic valve thrombosis (PVT) and obstruction are rare and dangerous events often related to inappropriate anticoagulant therapy. High mortality rates occur because of delayed diagnosis, hemodynamic instability, multiple organ failure (MOF), and high perioperative risk. Surgical repai...

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Bibliographic Details
Published in:Curēus (Palo Alto, CA) CA), 2024-03, Vol.16 (3), p.e55944
Main Authors: Alves Cabrita, Joana, Barrigoto, Cleide, Maia, Raquel, Oliveira, Maria João, Fortuna, Philip
Format: Article
Language:English
Subjects:
Anesthesiology
Anticoagulants
Blood clots
Cardiac/Thoracic/Vascular Surgery
Case reports
Emergency medical care
Extracorporeal membrane oxygenation
Heart surgery
Hemodynamics
Hemoglobin
Hemoptysis
Hypertension
Internal Medicine
Leukocytes
Lungs
Medical imaging
Patients
Prostheses
Pulmonary arteries
Respiratory failure
Thrombosis
Transplants & implants
Veins & arteries
Ventilators
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Summary:Mechanical prosthetic valve thrombosis (PVT) and obstruction are rare and dangerous events often related to inappropriate anticoagulant therapy. High mortality rates occur because of delayed diagnosis, hemodynamic instability, multiple organ failure (MOF), and high perioperative risk. Surgical repair is a first-line treatment for obstructive PVT with hemodynamic instability but is often not readily available or safely performed. Venoarterial extracorporeal membrane oxygenation (VA ECMO) support has been increasingly used in patients with PVT and cardiorespiratory collapse, allowing MOF reversal and safer deferred surgery. The authors present a case of a young female with refractory cardiogenic shock secondary to mitral PVT successfully managed with VA ECMO. Furthermore, the promising role of perioperative VA ECMO support for PVT-related cardiogenic shock is also discussed.
ISSN:2168-8184
2168-8184
DOI:10.7759/cureus.55944