Mechanical pulmonic valve thrombosis: expanding role of cardiac CT and multimodality imaging |
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| Authors: | Ahmed A. Kolkailah Talal Asif Fady H. Iskander Javier Gomez-Valencia Saurabh Malhotra |
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| Affiliation: | aDivision of Cardiology, University of Texas Southwestern Medical Center, Dallas, TX, USA;bDivision of Cardiology, University Health Truman Medical Center, University of Missouri, Kansas City, MO, USA;cDivision of Cardiology, Medstar Heart and Vascular Institute, Baltimore, MD, USA;dDivision of Cardiology, Cook County Health, Chicago, IL, USA;eDivision of Cardiology, Rush Medical College, Chicago, IL, USA |
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| Abstract: | We report a case of a 44-year-old man with a clinical history of Tetralogy of Fallot status post staged surgical correction with mechanical pulmonic valve replacement who presented with progressive exertional dyspnea in the setting of non-compliance with anticoagulation. In the context of this suggestive clinical presentation, the diagnosis of mechanical pulmonic valve thrombosis (MPVT) was made possible via multimodality imaging, including transthoracic echocardiogram and cardiac computed tomography angiography. Due to the uncommon nature of the condition, the patient was treated with systemic thrombolysis and anticoagulation using evidence-based guidelines, largely extrapolated from left-sided mechanical valve thrombosis. Our case underscores the importance of anticoagulation in MPVT and recognizing the features of MPVT on clinical history, physical examination, and multimodality imaging. It is essential to understand the pivotal role of multimodality imaging in the assessment of MPVT and realize the limitations of available data regarding the management of MPVT in the current era. |
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| Keywords: | Mechanical pulmonic valve thrombosis Cardiac computed tomography angiography Multimodality imaging Anticoagulation Systemic thrombolysis Evidence-based guidelines |
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