This case highlights the critical need for serial phonoechocardiographic monitoring in patients with prosthetic valves to detect clinically silent but fatal complications like massive thrombosis and valve degeneration.
Silent fatal bioprosthetic thrombosis highlights monitoring gaps; case report leaves open whether routine serial imaging improves survival.
A 43 year old man with a Hancock porcine bioprosthetic valve in the mitral position developed a huge thrombus filling the entire left atrium and chronic degeneration of the bioprosthetic mitral valve. The effective valve orifice was less than 2 mm. These severe findings leading to the patient's death remained undetected while he was alive. This case illustrates the great need for a serial phonoechocardiographic studies in all patients with prosthetic valves.
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Zoneraich et al. (1985) studied this question.
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