Acute Intraoperative Bioprosthetic Valve Thrombosis Immediately After Protamine Administration

Peng Teng; Shuai Yuan; Yiming Ni; Shengjun Wu

doi:10.1016/j.amjcard.2023.04.018

Acute Intraoperative Bioprosthetic Valve Thrombosis Immediately After Protamine Administration

Am J Cardiol. 2023 Jul 1:198:92-94. doi: 10.1016/j.amjcard.2023.04.018. Epub 2023 May 15.

Authors

Peng Teng¹, Shuai Yuan², Yiming Ni¹, Shengjun Wu³

Affiliations

¹ Departments of Cardiovascular Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang University.
² Echocardiography and Vascular Ultrasound Center, The First Affiliated Hospital, College of Medicine, Zhejiang University.
³ Departments of Cardiovascular Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang University. Electronic address: wsjsw@zju.edu.cn.

PMID: 37198074
DOI: 10.1016/j.amjcard.2023.04.018

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.

Publication types

Case Reports
Research Support, Non-U.S. Gov't

MeSH terms

Bioprosthesis* / adverse effects
Echocardiography, Transesophageal / adverse effects
Heart Valve Prosthesis* / adverse effects
Humans
Protamines / adverse effects
Thrombosis* / diagnostic imaging
Thrombosis* / drug therapy
Thrombosis* / etiology

Substances

Protamines