Abstract
The valve replacement for valvular disease has been safely performed with a recent development in cardiac valve prosthesis. However, there are increasing cases obliged to undergo re-replacement in a late period after the operation. Recently, we successfully performed a re-replacement with a mechanical valve because of valve failure and left atrial thrombosis after replacement with a bioprosthesis.
A 34-year-old female underwent a replacement of Hancock bioprosthesis for mitral stenosis seven years before when she was 27 years old.
Postoperative anticoagulants were not administered, and she successfully delivered. Eight years later, she had mitral regurgitation causing prosthetic insufficiency and left atrial thrombosis. Re-replacement using mechanical valves (SJM 29 mm) and left atrial thrombectomy were carried out. The postoperative course was uneventful and she was discharged from the hospital 2 months after the reoperation. In this case the huge thrombosis was in the left atrial wall and no direct correlation with the eplaced bioprosthesis was thought. Even for the replacement using a bioprosthesis, anticoagulant regimen appears necessary as a rule.
