Key result
Suboptimal anticoagulation leads to fatal mechanical mitral valve obstruction from combined pannus and thrombus.
Why the study?
Mechanical prosthetic valve dysfunction in the mitral position is a rare but highly serious complication requiring timely diagnosis and differentiation between thrombosis and pannus.
Case Report (n=1)
This case emphasizes the fatal nature of obstructive mechanical mitral prosthesis dysfunction due to pannus and thrombus, highlighting the critical need for timely diagnosis and adequate anticoagulation.
Fatal mechanical mitral prosthesis obstruction signals diagnostic urgency; single case leaves open optimal anticoagulation strategies.
Mechanical prosthetic valve dysfunction is a rare but highly serious complication, particularly in the mitral position. We present the case of a 40-year-old female patient with a history of rheumatic heart disease, mechanical mitral valve replacement, and suboptimal anticoagulation, who was admitted with severe dyspnea, acute pulmonary edema, and a focal neurological deficit consistent with ischemic stroke. Transthoracic echocardiography revealed increased transprosthetic gradients and restricted valve mobility, while transesophageal echocardiography confirmed a mass consistent with a thrombus associated with pannus, causing obstructive dysfunction of the mitral prosthesis. Despite intensive care unit management, ventilatory support, and the medical treatment initiated, the patient’s clinical course was unfavorable, characterized by refractory acute pulmonary edema and progressive neurological deterioration; she passed away during hospitalization. This case highlights the importance of timely diagnosis and the differentiation between thrombosis.
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Reinaga et al. (2026) conducted a case report in Obstructive dysfunction of a mechanical mitral prosthesis (n=1). Suboptimal anticoagulation and mechanical mitral prosthesis was evaluated. Suboptimal anticoagulation in a 40-year-old woman with a mechanical mitral prosthesis resulted in fatal obstructive dysfunction caused by pannus and thrombus.
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