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Review
. 2008 May;24(5):401-3.
doi: 10.1016/s0828-282x(08)70605-6.

Tricuspid valve thrombus: a case report associated with gonadotropin-releasing hormone analogue therapy and review of the literature

Ibrahim Basarici  1 , Aytul Belgi, Selim Yalcinkaya
Affiliations
Review

Tricuspid valve thrombus: a case report associated with gonadotropin-releasing hormone analogue therapy and review of the literature

Ibrahim Basarici et al. Can J Cardiol. 2008 May.

Abstract
in English, French

A 35-year-old woman with a previously repaired atrial septal defect was referred for preoperative evaluation before laparoscopic surgery. The patient was asymptomatic, and a transesophageal echocardiographic examination revealed a probable thrombus attached to the tricuspid valve. The patient's history included therapy with a gonadotropin-releasing hormone analogue and deep venous thrombosis five months earlier. The tricuspid valve thrombus disappeared after anticoagulant therapy. Warfarin was initiated for prophylaxis. During the follow-up, the patient was event-free during laparoscopic surgery and pregnancy (when warfarin was switched to acetylsalicylic acid) and gave birth to a healthy term baby. Because etiological investigations revealed no reason for the tricuspid valve thrombus, it was considered to be related to the procoagulant state induced by hormonal treatment. The patient was scheduled for close follow-up.

Une femme de 35 ans ayant des antécédents de chirurgie pour correction d’une communication interauriculaire est adressée pour évaluation préopératoire en vue d’une chirurgie laparoscopique. La patiente était asymptomatique, mais l’examen échocardiographique transœsophagien a révélé la présence d’un thrombus probable fixé à la valvule tricuspidienne. Les antécédents de la patiente incluaient un traitement par analogue de la gonadolibérine et une thrombose veineuse profonde, cinq mois auparavant. Le thrombus valvulaire tricuspidien est disparu après un traitement anticoagulant. La warfarine a été instaurée en prophylaxie. Au cours du suivi, la patiente n’a présenté aucune complication lors de sa chirurgie laparoscopique et de sa grossesse (lorsque la warfarine a été remplacée par de l’acide acétylsalicylique) et elle a donné naissance à un bébé à terme et en bonne santé. Comme les examens étiologiques n’ont pu donner d’explication à la présence du thrombus valvulaire tricuspidien, on l’a jugé en lien avec l’état procoagulant induit par le traitement hormonal. La patiente doit faire l’objet d’un suivi étroit.

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Figures

Figure 1)
Figure 1)
Transesophageal echocardiographic image displaying a sessile echogenic mass (thrombus [Tr]) attached to the atrial side of the tricuspid valve (TV). LA Left atrium; LV Left ventricle; RA Right atrium; RV Right ventricle
Figure 2)
Figure 2)
Control transesophageal echocardiographic image displaying regression of the size of the thrombus (Tr). AO Aorta; LA Left atrium; RA Right atrium; RV Right ventricle
See this image and copyright information in PMC

References

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