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• W4387475889 abstract "Abstract Background: Mitral valve stenosis can be a highly symptomatic condition with significant complications if left untreated. In such cases, mitral valve replacement with a bioprosthetic or mechanical valve may be a viable solution to prevent progressive disease. Current guidelines do not recommend continued anticoagulation beyond six months for patients who have undergone bioprosthetic valve replacement without a separate indication for anticoagulation. With this case discussion we aim to 1) Review the current indications for anticoagulation for bioprosthetic mitral valves in patients without atrialfibrillation and 2) Discuss the constellation of comorbidities that may affect the decision to begin anticoagulation therapy. Case presentation : We present a case describing a 55-year-old male with end-stage renal disease, coronary artery disease with coronary artery bypass graft surgery, and bioprosthetic mitral valve replacement two years prior with rapid degeneration of the replaced valve and on warfarin without a clear indication for anticoagulation. The patient was admitted for symptomatic, severe mitral stenosis and consideration of transcatheter mitral valve-in-valve replacement. During hospital admission, warfarin was discontinued and replaced with prophylactic anticoagulation. However, eight days after warfarin cessation an intraoperative transesophageal echocardiogram revealed a newly developed large left atrial thrombus leading to cancellation of the planned operation. Conclusions: This patient developed a left atrial thrombus after discontinuing warfarin in the setting of rapidly deteriorating bioprosthetic valve stenosis and vascular comorbidities. The decision to discontinue warfarin was made in concordance with current guidelines, which do not indicate systemic anticoagulation post 3-6 months after bioprosthetic valve replacement without separate indication for anticoagulation. This case identifies the need to investigate rebound hypercoagulability and further risk stratify comorbidities which may independently increase the risk of clot formation in the setting of severe mitral valve stenosis." @default.
• W4387475889 created "2023-10-11" @default.
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• W4387475889 date "2023-10-10" @default.
• W4387475889 modified "2023-10-16" @default.
• W4387475889 title "Left Atrial Thrombus Formation after Discontinuation of Anticoagulation in Patient with Severe Bioprosthetic Mitral Stenosis" @default.
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• W4387475889 doi "https://doi.org/10.21203/rs.3.rs-3383326/v1" @default.
• W4387475889 hasPublicationYear "2023" @default.
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