Thrombosed prosthetic mitral valve.

1 of 2 DESCRIPTION A 29-year-old woman presented with pulmonary oedema and low cardiac output. Her mitral valve was replaced 20 years back with a Sorin mechanical valve. She had stopped anticoagulants a month back on her own for excessive menstrual bleeding. Echo showed a gradient of 26 mm Hg across the valve with regurgitation. Fluroscopy confi rmed limited disc opening of only 15° with incomplete disc closure ( fi gures 1 and 2 ) ( videos 1 and 2 ). She was reoperated using a St Jude mechanical valve. The excised prosthetic valve showed thrombus and pannus almost completely occluding the disc and severely restricting disc mobility ( fi gures 3 and 4 ).