Early Postoperative Immunothrombosis of Bioprosthetic Mitral Valve and Left Atrium: A Case Report

Autor: Alexander Kostyunin, Tatiana Glushkova, Alexander Stasev, Rinat Mukhamadiyarov, Elena Velikanova, Leo Bogdanov, Anna Sinitskaya, Maxim Asanov, Evgeny Ovcharenko, Leonid Barbarash, Anton Kutikhin
Jazyk: angličtina
Rok vydání: 2022
Předmět:
Zdroj: International Journal of Molecular Sciences, Vol 23, Iss 12, p 6736 (2022)
Druh dokumentu: article
ISSN: 23126736
1422-0067
1661-6596
75999056
DOI: 10.3390/ijms23126736
Popis: A 72-year-old female patient with mixed rheumatic mitral valve disease and persistent atrial fibrillation underwent mitral valve replacement and suffered from a combined thrombosis of the bioprosthetic valve and the left atrium as soon as 2 days post operation. The patient immediately underwent repeated valve replacement and left atrial thrombectomy. Yet, four days later the patient died due to the recurrent prosthetic valve and left atrial thrombosis which both resulted in an extremely low cardiac output. In this patient’s case, the thrombosis was notable for the resistance to anticoagulant therapy as well as for aggressive neutrophil infiltration and release of neutrophil extracellular traps (NETs) within the clot, as demonstrated by immunostaining. The reasons behind these phenomena remained unclear, as no signs of sepsis or contamination of the BHV were documented, although the patient was diagnosed with inherited thrombophilia that could impede the fibrinolysis. The described case highlights the hazard of immunothrombosis upon valve replacement and elucidates its mechanisms in this surgical setting.
Databáze: Directory of Open Access Journals
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