A Case Report of Acute Thrombotic Obstruction of the On-X Mitral Valve Prosthesis
	    		
	    			
	    			
		        		
			        		
		        		
			        
		   		
		   		
		   			
		   		
	    	
    	 
    	10.4326/jjcvs.38.114
   		
        
        	
        		- VernacularTitle:巨大血栓による急性開放制限をきたした僧帽弁位 On-X 弁の1例
 
        	
        	
        	
        		- Author:
	        		
		        		
		        		
			        		Jiro Honda
			        		
			        		;
		        		
		        		
		        		
			        		Toshimi Yonaha
			        		
			        		;
		        		
		        		
		        		
			        		Keiichiro Kuroki
			        		
			        		
		        		
		        		
		        		
		        		
		        		
			        		
			        		
		        		
	        		
        		 
        	
        	
        	
        		- Publication Type:Journal Article
 
        	
        	
            
            
            	- From:Japanese Journal of Cardiovascular Surgery
	            		
	            		 2009;38(2):114-118
	            	
            	
 
            
            
            	- CountryJapan
 
            
            
            	- Language:Japanese
 
            
            
            	- 
		        	Abstract:
			       	
			       		
				        
				        	A 39-year-old woman underwent aortic valve replacement (AVR) with a 21 mm St Jude Medical prosthesis and mitral valve replacement (MVR) with a 27/29 mm On-X valve prosthesis when she was 38-year-old, and she was discharged uneventfully. Five months after the operation, she was admitted with aggravated dyspnea. Upon admission she went into serious heart failure, followed by cardiogenic shock. Cineradiography showed a restricted opening of the On-X mitral valve prosthesis and transesophageal echocardiography demonstrated thrombus formation on the mitral valve annulus. We diagnosed thrombosed valve and reoperated urgently. Intraoperatively we found a large amount of fresh thrombus extending from the sewing cuff that restricted valve motion. The valve was cleaned and left in place. Although the heart recovered well, she lost some neurologic functions and was transferred to another hospital for rehabilitation. We also investigated the opening angle of the On-X mitral prosthesis in other patients who had clinically normal valve function.