Acute Intraoperative Bioprosthetic Valve Thrombosis Immediately After Protamine Administration
Abstract
Acute bioprosthetic valve thrombosis (BPVT) is considered a rare complication and has seldom been described. Moreover, acute intraoperative BPVT is exceedingly rare, and its management remains a major clinical challenge. Here, we report a case of acute intraoperative BPVT that occurred immediately after protamine administration. Major resolution of the thrombus and significant improvement of bioprosthetic function were observed after the resumption of cardiopulmonary bypass support for approximately 1 hour. Intraoperative transesophageal echocardiography is important for a prompt diagnosis. Our case describes the spontaneous resolution of BPVT after reheparinization, which might assist in the management of acute intraoperative BPVT.
Bioprosthetic valve thrombosis (BPVT) is a rare but potentially fatal complication of bioprosthetic valves. Although BPVT most commonly occurs in the first 3 months after implantation, with a second peak incidence 1 to 2 years after implantation, several cases of early acute BPVT from postoperative day (POD) 2 to 9 have been reported.
The management of postoperative BPVT has been well described.
However, acute intraoperative BPVT is exceedingly rare, and experience in its intraoperative management remains lacking. Here, we present a case of acute intraoperative BPVT that occurred immediately after protamine administration. To the best of our knowledge, such a case has not yet been reported.