Abstract

Obstruction of mechanical aortic valve is a rare but serious complication associated with a high mortality rate that frequently follows thrombosis – due to regional clotting or, less often, due to endocarditis. Thrombosis of mechanical heart valve depends on certain factors such as lifestyle, coagulation status, valve position, presence of atrial fibrillation and ventricular dysfunction. 70-year-old patient is admitted to the On-Call Department for moderate-severe dyspnea with progressive onset over the last month with a history of a prior aortic valve replacement. An echocardiogram reveals a dysfunctional metallic aortic prosthesis. He undergoes a surgical intervention for mechanical valve replacement with iterative median sternotomy and a meticulous dissection of the pleuro-pericardial adhesions. Post operative evolution in the ICU is followed by SIRS.The patient goes into a GCS 4 coma and the neurological examination presumes a recent stroke.

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