Mitral Valve Prosthesis Dehiscence with Severe Regurgitation and Pseudoaneurysm in a Young Woman with Recurrent Nonbacterial Thrombotic Endocarditis

Nonbacterial thrombotic endocarditis (NBTE) is a noninfectious cause of valvular vegetations. Although NBTE is most commonly associated with malignancy, it is also seen in patients with hypercoagulable states such as burns, sepsis, and hemolytic anemias and, most important, in autoimmune diseases such as systemic lupus erythematosus (SLE) and antiphospholipid syndrome (APS).1 The exact pathogenesis of NBTE is not well understood but is thought to be secondary to endothelial damage, with subsequent deposition of platelets and inflammatory cells, ultimately forming thrombi mixed with strands of fibrin and immune complexes.