A 70-year-old male experienced early double bioprosthetic valve failure with subsequent SIRS and died within 24 hours post-surgery due to suspected autoimmune-mediated thrombosis.
This case highlights the potential role of autoimmune-mediated valve thrombosis (elevated anti-cardiolipin IgM) in early structural valve degeneration of bioprosthetic valves.
Absolute Event Rate: 0% vs 0%
Introduction Bioprosthetic heart valves (BHVs) are increasingly used in valvular heart disease, offering favourable haemodynamics and lower thrombogenic risk compared to mechanical valves. However, long-term durability remains limited by structural valve degeneration (SVD). Case report A 70-year-old male presented with severe heart failure 4 years after bioprosthetic mitral and aortic valve replacement. Imaging confirmed SVD affecting both valves, necessitating high-risk redo surgery. Postoperatively, the patient developed profound systemic inflammatory response syndrome (SIRS) to cardiopulmonary bypass (CPB), refractory to vasopressors and steroids, and died within 24 hours. Discussion Further investigations revealed elevated isolated anti-cardiolipin IgM antibodies, raising suspicion of autoimmune-mediated valve thrombosis as a contributor to this case of early SVD. Conclusion This case highlights the importance of thorough diagnostic evaluation in cases of early SVD, the need to individualise anticoagulation strategies in at-risk patients, and serves as a critical reminder of the serious inflammatory complications that can occur post-surgery.
Guo et al. (Wed,) reported a other. A 70-year-old male experienced early double bioprosthetic valve failure with subsequent SIRS and died within 24 hours post-surgery due to suspected autoimmune-mediated thrombosis.