International Journal of Cardiovascular and Thoracic Surgery

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Obstructive Thrombosis of a Mitral Prosthetic Valve in the Context of COVID-19 in Senegal

COVID-19 causes a hypercoagulable state, predisposing to a thrombotic state, particularly in patients with mechanical valve. Thrombosis of a prosthetic valve is a rare but serious complication of valve replacement by mechanical prosthesis. It is a medical and surgical emergency. Diagnosis is based primarily on trans-thoracic echocardiography. All obstructive thromboses of the left heart require surgery. We report the case of a 30-year-old female patient with a background COVID-19 infection who presented with New York Heart Association (NYHA) class III dyspnea, chest pain and fever, a transthoracic echocardiography showed obstructive mechanical mitral valve thrombosis. She was hospitalized in the cardiology department and anticoagulant therapy was initiated. The mechanical valve was, then, removed. On H15 postoperatively she was febrile with a temperature of (40°C), the pupils were isocoric, and there was a decerebrate rigidity, however, her hemodynamic state was stable. The PCR test result for COVID-19 was positive 15 hours after the surgery, a thoracic computer tomography angiography scan revealed a mild form of COVID-19. A brain computer tomography scan revealed a COVID-19 encephalopathy. Unfortunately at H20, the infectious workup showed leucocytosis and a positive CRP, which required initiating empiric antibiotic therapy with ceftriaxone and gentamicin awaiting for microscopy, culture and sensitivity results. Treatment with methylprednisolone was also started. The dose of immediate postoperative anticoagulation was maintained at 200 IU/Kg/D. On H24 her Glasgow Coma Scale was 3/15, pupils were fixed and dilated with loss of brainstem reflexes. Death was declared at Day 2 postoperatively as a result of neurological complications. Standard prophylactic and therapeutic protocols need to be reviewed when COVID-19 occurs in a patient with a mechanical valve prosthesis.

Mechanical Valve Thrombosis, COVID-19, Anticoagulation

APA Style

Ba Papa Ousmane, Diagne Papa Amath, Diop Momar Sokhna, Ismael Ibouroi Moina-Hanifa, Ikponmwosa Gold, et al. (2023). Obstructive Thrombosis of a Mitral Prosthetic Valve in the Context of COVID-19 in Senegal. International Journal of Cardiovascular and Thoracic Surgery, 9(4), 51-55. https://doi.org/10.11648/j.ijcts.20230904.12

ACS Style

Ba Papa Ousmane; Diagne Papa Amath; Diop Momar Sokhna; Ismael Ibouroi Moina-Hanifa; Ikponmwosa Gold, et al. Obstructive Thrombosis of a Mitral Prosthetic Valve in the Context of COVID-19 in Senegal. Int. J. Cardiovasc. Thorac. Surg. 2023, 9(4), 51-55. doi: 10.11648/j.ijcts.20230904.12

AMA Style

Ba Papa Ousmane, Diagne Papa Amath, Diop Momar Sokhna, Ismael Ibouroi Moina-Hanifa, Ikponmwosa Gold, et al. Obstructive Thrombosis of a Mitral Prosthetic Valve in the Context of COVID-19 in Senegal. Int J Cardiovasc Thorac Surg. 2023;9(4):51-55. doi: 10.11648/j.ijcts.20230904.12

Copyright © 2023 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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