Acute postoperative thrombosis of an aortic valve prosthesis and embolic myocardial infarction in a coronavirus disease 2019 (COVID-19)-positive patient-an unrecognized complication.

Abstract

A 73 year old female patient presented 14 days post aortic valve replacement (AVR) for bicuspid valve stenosis; she was diagnosed with COVID-19 infection, acute myocardial infarction, pulmonary embolism and retinal artery embolism. CT identified extensive thrombus formation on the valve struts. This demonstrated complete resolution at 11 weeks with warfarin therapy. Although venous thromboembolism is now well-documented in COVID-19 patients, this case highlights the increased risks of systemic arterial embolism following recent cardiac procedures; it also serves as a timely reminder of the consequences of COVID-19 and the radiological vigilance required in identifying AVR thrombosis on acute cardiothoracic CT. The observations made warrant careful thought with respect to perioperative anticoagulation strategy.