Key result
Repeated thrombolysis fails to prevent recurrent mechanical tricuspid valve thrombosis requiring surgical re-replacement.
Case Report (n=1)
Highlights the high risk of recurrent thrombosis with mechanical prostheses in the tricuspid position despite adequate anticoagulation and repeated thrombolysis, ultimately necessitating bioprosthetic replacement.
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Recurrent tricuspid mechanical valve thrombosis despite anticoagulation may support bioprosthetic consideration; leaves open optimal prosthesis selection post-trauma.
We discuss the case of a 50-year-old man who underwent tricuspid valve replacement with a mechanical prosthesis (Duromedics) due to traumatic tricuspid insufficiency following a blunt chest trauma fifteen years previously. Despite correct anticoagulation therapy several events of prosthetic valve thrombosis occurred in the following years. The patient was treated four times by thrombolytic therapy. Finally, seven years after the initial operation the mechanical valve was replaced by a Carpentier-Edwards bioprosthesis because of complete blockage.
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Cottogni et al. (1993) conducted a case report in Traumatic tricuspid insufficiency and recurrent prosthetic valve thrombosis (n=1). Thrombolytic therapy (4 courses) followed by replacement with a Carpentier-Edwards bioprosthesis was evaluated on Complete prosthetic valve blockage requiring redo valve replacement. Thrombolytic therapy administered 4 times failed to prevent complete blockage of a mechanical tricuspid prosthesis, requiring bioprosthetic replacement after 7 years.
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