@article{10.11648/j.ijcts.20230904.12,
  author = {Ba Papa Ousmane and Diagne Papa Amath and Diop Momar Sokhna and Ismael Ibouroi Moina-Hanifa and Ikponmwosa Gold and Dioum Momar and Ba El Hadj Boubacar and Bizrane Myriam and Ba Papa Salmane and Ciss Amadou Gabriel},
  title = {Obstructive Thrombosis of a Mitral Prosthetic Valve in the Context of COVID-19 in Senegal},
  journal = {International Journal of Cardiovascular and Thoracic Surgery},
  volume = {9},
  number = {4},
  pages = {51-55},
  doi = {10.11648/j.ijcts.20230904.12},
  url = {https://doi.org/10.11648/j.ijcts.20230904.12},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijcts.20230904.12},
  abstract = {COVID-19 causes a hypercoagulable state, predisposing to a thrombotic state, particularly in patients with mechanical valve. Thrombosis of a prosthetic valve is a rare but serious complication of valve replacement by mechanical prosthesis. It is a medical and surgical emergency. Diagnosis is based primarily on trans-thoracic echocardiography. All obstructive thromboses of the left heart require surgery. We report the case of a 30-year-old female patient with a background COVID-19 infection who presented with New York Heart Association (NYHA) class III dyspnea, chest pain and fever, a transthoracic echocardiography showed obstructive mechanical mitral valve thrombosis. She was hospitalized in the cardiology department and anticoagulant therapy was initiated. The mechanical valve was, then, removed. On H15 postoperatively she was febrile with a temperature of (40°C), the pupils were isocoric, and there was a decerebrate rigidity, however, her hemodynamic state was stable. The PCR test result for COVID-19 was positive 15 hours after the surgery, a thoracic computer tomography angiography scan revealed a mild form of COVID-19. A brain computer tomography scan revealed a COVID-19 encephalopathy. Unfortunately at H20, the infectious workup showed leucocytosis and a positive CRP, which required initiating empiric antibiotic therapy with ceftriaxone and gentamicin awaiting for microscopy, culture and sensitivity results. Treatment with methylprednisolone was also started. The dose of immediate postoperative anticoagulation was maintained at 200 IU/Kg/D. On H24 her Glasgow Coma Scale was 3/15, pupils were fixed and dilated with loss of brainstem reflexes. Death was declared at Day 2 postoperatively as a result of neurological complications. Standard prophylactic and therapeutic protocols need to be reviewed when COVID-19 occurs in a patient with a mechanical valve prosthesis.},
 year = {2023}
}

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TY  - JOUR
T1  - Obstructive Thrombosis of a Mitral Prosthetic Valve in the Context of COVID-19 in Senegal
AU  - Ba Papa Ousmane
AU  - Diagne Papa Amath
AU  - Diop Momar Sokhna
AU  - Ismael Ibouroi Moina-Hanifa
AU  - Ikponmwosa Gold
AU  - Dioum Momar
AU  - Ba El Hadj Boubacar
AU  - Bizrane Myriam
AU  - Ba Papa Salmane
AU  - Ciss Amadou Gabriel
Y1  - 2023/08/05
PY  - 2023
N1  - https://doi.org/10.11648/j.ijcts.20230904.12
DO  - 10.11648/j.ijcts.20230904.12
T2  - International Journal of Cardiovascular and Thoracic Surgery
JF  - International Journal of Cardiovascular and Thoracic Surgery
JO  - International Journal of Cardiovascular and Thoracic Surgery
SP  - 51
EP  - 55
PB  - Science Publishing Group
SN  - 2575-4882
UR  - https://doi.org/10.11648/j.ijcts.20230904.12
AB  - COVID-19 causes a hypercoagulable state, predisposing to a thrombotic state, particularly in patients with mechanical valve. Thrombosis of a prosthetic valve is a rare but serious complication of valve replacement by mechanical prosthesis. It is a medical and surgical emergency. Diagnosis is based primarily on trans-thoracic echocardiography. All obstructive thromboses of the left heart require surgery. We report the case of a 30-year-old female patient with a background COVID-19 infection who presented with New York Heart Association (NYHA) class III dyspnea, chest pain and fever, a transthoracic echocardiography showed obstructive mechanical mitral valve thrombosis. She was hospitalized in the cardiology department and anticoagulant therapy was initiated. The mechanical valve was, then, removed. On H15 postoperatively she was febrile with a temperature of (40°C), the pupils were isocoric, and there was a decerebrate rigidity, however, her hemodynamic state was stable. The PCR test result for COVID-19 was positive 15 hours after the surgery, a thoracic computer tomography angiography scan revealed a mild form of COVID-19. A brain computer tomography scan revealed a COVID-19 encephalopathy. Unfortunately at H20, the infectious workup showed leucocytosis and a positive CRP, which required initiating empiric antibiotic therapy with ceftriaxone and gentamicin awaiting for microscopy, culture and sensitivity results. Treatment with methylprednisolone was also started. The dose of immediate postoperative anticoagulation was maintained at 200 IU/Kg/D. On H24 her Glasgow Coma Scale was 3/15, pupils were fixed and dilated with loss of brainstem reflexes. Death was declared at Day 2 postoperatively as a result of neurological complications. Standard prophylactic and therapeutic protocols need to be reviewed when COVID-19 occurs in a patient with a mechanical valve prosthesis.
VL  - 9
IS  - 4
ER  - 

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