title: Fluoroscopy-guided thrombolysis of mechanical mitral valve thrombosis in a young female with antiphospholipid antibody syndrome.
abstract: Prosthetic valve thrombosis (PVT) is a rare but potentially fatal complication of mechanical valve prosthesis. The differential diagnoses for prosthetic valve obstruction includes pannus formation, prosthetic valve dehiscence, prosthetic valve endocarditis, chordae entrapment, patient-prosthesis mismatch and primary device failure. Establishing a diagnosis requires an understanding of prosthetic valve haemodynamics and careful correlation of clinical and imaging findings. Definitive therapy must be individualised based on various patient-specific factors. We present a case of mechanical mitral PVT in a young woman with antiphospholipid antibody syndrome, and outline the diagnostic and therapeutic approach utilised for successful treatment. The success and complication rates of various therapeutic strategies are also discussed, and highlight the need for individualised decision-making rather than a one-size-fits-all approach to PVT.
authors.affiliation: Department of Cardiovascular Medicine, University of Louisville, Louisville, KY.
authors.forename: Sohail
authors.initials: S
authors.lastname: Ikram
authors.affiliation: Department of Cardiovascular Medicine, University of Louisville, Louisville, KY.
authors.forename: Sadip
authors.initials: S
authors.lastname: Pant
authors.affiliation: Department of Internal Medicine, University of Louisville, KY.
authors.forename: Zeeshan
authors.initials: Z
authors.lastname: Hussain
authors.affiliation: Department of Cardiovascular Medicine, University of Louisville, Louisville, KY.
authors.forename: Lorrel
authors.initials: L
authors.lastname: Brown
mesh_terms: D000328:Adult; D016736:Antiphospholipid Syndrome / Q000150:complications*; D003937:Diagnosis, Differential; D005260:Female; D005471:Fluoroscopy; D006349:Heart Valve Diseases / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy*; D006350:Heart Valve Prosthesis; D006801:Humans; D008943:Mitral Valve; D015912:Thrombolytic Therapy / Q000379:methods*; D013927:Thrombosis / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy*; D016896:Treatment Outcome