A Case of Acute Mechanical Mitral Valve Thrombosis Management With Venoarterial Extracorporeal Membrane Oxygenation

Abstract

Mechanical prosthetic valve thrombosis (PVT) and obstruction are rare and dangerous events often related to inappropriate anticoagulant therapy. High mortality rates occur because of delayed diagnosis, hemodynamic instability, multiple organ failure (MOF), and high perioperative risk. Surgical repair is a first-line treatment for obstructive PVT with hemodynamic instability but is often not readily available or safely performed. Venoarterial extracorporeal membrane oxygenation (VA ECMO) support has been increasingly used in patients with PVT and cardiorespiratory collapse, allowing MOF reversal and safer deferred surgery. The authors present a case of a young female with refractory cardiogenic shock secondary to mitral PVT successfully managed with VA ECMO. Furthermore, the promising role of perioperative VA ECMO support for PVT-related cardiogenic shock is also discussed.

Keywords: cardiogenic shock; case report; mechanical mitral valve complications; mitral valve surgery; prosthetic valve thrombosis; va-ecmo.