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Case Reports
. 2021 Jun;37(6):938.e3-938.e6.
doi: 10.1016/j.cjca.2020.10.008. Epub 2020 Oct 24.

Bioprosthetic Valve Thrombosis and Obstruction Secondary to COVID-19

Guillem Llopis Gisbert  1 , Verónica Vidal Urrutia  2 , Miguel A Moruno Benita  2 , Ana Payá Chaume  2 , Alberto Berenguer Jofresa  2 , Andrés M Cubillos Arango  2 , José L Pérez Boscá  2 , Rafael Payá Serrano  2
Affiliations
Case Reports

Bioprosthetic Valve Thrombosis and Obstruction Secondary to COVID-19

Guillem Llopis Gisbert et al. Can J Cardiol. 2021 Jun.

Abstract
in English, French

Patients with COVID-19 may present a hypercoagulable state, with an important impact on morbidity and mortality. Because of this situation pulmonary embolism is a frequent complication during the course of infection. We present the case of a patient recently discharged, after admission with confirmed COVID-19, who developed a pulmonary embolism and thrombosis of a biological mitral valve prosthesis, producing valve obstruction and stenosis. After 15 days of anticoagulant treatment, resolution of the thrombus and normalisation of prosthetic valve function was observed. This case supports current recommendations of administering full-dose anticoagulation therapy to COVID-19 patients with biological heart valve prosthesis, even after the acute phase of infection.

Les patients atteints de COVID-19 présentent parfois une hypercoagulabilité, ce qui a un retentissement important sur la morbidité et la mortalité. C’est pour cette raison que l’embolie pulmonaire est une complication fréquemment observée chez les patients infectés. Nous présentons le cas d’un patient ayant récemment obtenu son congé de l’hôpital après avoir contracté la COVID-19, qui a présenté une embolie pulmonaire et une thrombose de prothèse mitrale biologique provoquant l’obstruction et la sténose de la valve. Après 15 jours d’anticoagulothérapie, la thrombose s’est résorbée et la prothèse valvulaire fonctionne de nouveau normalement. Ce cas milite en faveur des recommandations actuelles concernant l’administration d’une anticoagulothérapie à dose complète aux patients atteints de COVID-19 ayant une prothèse valvulaire biologique, même après la phase aiguë de l’infection.

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Figures

Figure 1
Figure 1
Transesophageal echocardiography (2-dimensional) on admission: mesoesophageal 2-chamber view showing thickened leaflets compatible with laminar thrombus with limited mitral valve opening (transmitral gradient of 19 mm Hg).
Figure 2
Figure 2
Transesophageal echocardiography (2-dimensional) 15 days later: mesoesophageal 2-chamber view showing resolution of prosthetic stenosis with thin leaflets and normal valve opening, only mild restriction of anterior mitral leaflet persisting with complete telediastolic opening (transmitral gradient of 5 mm Hg).
See this image and copyright information in PMC

Comment in

References

    1. Connors J.M., Levy J.H. COVID-19 and its implications for thrombosis and anticoagulation. Blood. 2020;135:2033–2040. - PMC - PubMed
    1. Chauhan A.J., Wiffen L.J., Brown T.P. COVID-19: a collision of complement, coagulation and inflammatory pathways. J Thromb Haemost. 2020;1:2110–2117. - PMC - PubMed
    1. Mestre-Gómez B., Lorente-Ramos R.M., Rogado J., et al. Incidence of pulmonary embolism in noncritically ill COVID-19 patients. Predicting factors for a challenging diagnosis. J Thromb Thrombolysis. 2021;51:40–46. - PMC - PubMed
    1. Langer F., Kluge S., Klamroth R., et al. Coagulopathy in COVID-19 and its implication for safe and efficacious thromboprophylaxis. Hamostaseologie. 2020;40:264–269. - PMC - PubMed
    1. Bikdeli B., Madhavan M.V., Jimenez D., et al. COVID-19 and thrombotic or thromboembolic disease: implications for prevention, antithrombotic therapy, and follow-up: JACC state-of-the-art review. J Am Coll Cardiol. 2020;75:2950–2973. - PMC - PubMed

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