LATE THROMBOTIC OBSTRUCTION OF AN AORTIC BIOPROSTHETIC VALVE - SUCCESSFUL TREATMENT BY ORAL ANTICOAGULATION

Thrombotic obstruction of aortic bioprostheses is rare. Few cases have been reported involving the use of the Carpentier-Edwards (CE) prosthesis, the Hancock bioprosthesis, or the Medtronic Intact porcine valve.1.4 Thrombolytic therapy for mechanical valve thrombosis has been used frequently even though it is known to carry a high fisk of embolism and recurrence.5 However, the use of this therapy was reported for the first time only recently,1 in a case of acute aortic thrombosis which occurred 31/2 months after bioprosthesis insertion. We report a case of late progressive thrombotic obstruction of a CE aortic valve 3 years after insertion. The case was successfully treated with coumadin therapy, as confirmed by serial Doppler echocardiographic examinations and a 3-year follow-up.