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Case Reports
. 2022 Oct;37(10):3417-3420.
doi: 10.1111/jocs.16761. Epub 2022 Jul 16.

Large tricuspid valve thrombus complicating COVID-19 pneumonia

Yasser A Kamal  1 , Shady E Al-Elwany  1 , Mostafa M Elsayed  1
Affiliations
Case Reports

Large tricuspid valve thrombus complicating COVID-19 pneumonia

Yasser A Kamal et al. J Card Surg. 2022 Oct.

Abstract

Background: Hemostatic disturbances with coronavirus disease 2019 (COVID-19) can predispose to tricuspid and right heart thrombi in very rare instances.

Aim: We describe a 29-year-old female patient without a previous cause of thrombosis who developed large tricuspid valve thrombus (TVT) and moderate-to-severe tricuspid regurgitation (TR) during the course of COVID-19 infection.

Materials and methods: Persistant fever and tachycardia with thrombocytopenia and high d-dimer increased the index of suspicion. The diagnosis was made by bedside transthoracic echocardiography (TTE) and cardiac magnetic resonance (CMR). Surgery was performed for thrombectomy and tricuspid valve replacement with a tissue valve.

Discussion and conclusion: Detection of TVT in COVID-19 patients on the basis of high index of suspicion, bedside TTE and noninvasive CMR helps early surgical treatment and subsequent reduction of mortality and hospital stay.

Keywords: COVID-19; cardiac magnetic resonance; hypercoagulation; thrombus; tricuspid valve.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Timline of in‐hospital diagnostic and therapeutic workup. CMR, cardiac magnetic resonance; MR, magnetic resonance; PCR, polymerase chain reaction; TTE, transthoracic echocardiography; TV, tricuspid valve.
Figure 2
Figure 2
Computed tomography of the chest shows consolidation and peripheral ground‐glass lung opacities (arrow).
Figure 3
Figure 3
Cardiac magnetic resonance shows tricuspid valve thrombus (white arrows).
Figure 4
Figure 4
Intraoperative view of tricuspid valve thrombus attached to septal leaflet (white arrow).
See this image and copyright information in PMC

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