Mitral valve apparatus preservation and early bioprosthetic thrombosis: a word of caution.

Mitral valve/surgery; thrombosis; bioprosthesis. (prosthesis M-25, BSA = 1,672 m2) and 6 mmHg (prosthesis M-27, BSA = 1,632 m2), respectively. Neither of the patients was receiving anticoagulants. The case of the youngest patient was more dramatic, because she was admitted to the emergency room with history suggesting paroxysmal acute atrial fibrillation and neurological signs of embolization 18 days after surgery. The transesophageal echocardiogram (TEE) revealed thrombosis affecting the left auricle, atrial wall, and atrial face of the prosthesis. These data were confirmed at the emergency reoperation, when a new mechanical prosthesis was implanted with resection of the leaflets and annular fixation of the papillary muscles.