Massive aortic valve thrombosis with free floating thrombus following transcatheter aortic valve replacement

An 86-year-old woman was hospitalized for rapidly progressive dyspnoea, severe sepsis, and initial echocardiographic signs of biventricular cardiac decompensation. The patient had a history of transcatheter aortic valve replacement (TAVR) 1.5 years ago due to severe aortic stenosis (26  mm CoreValve Evolut R, Medtronic, Minneapolis, Minnesota, USA). For further evaluation, a contrast-enhanced multidetector computed tomography (MDCT) scan of the chest was performed. Multidetector computed tomography revealed a massive, free-floating thrombus in the ascending aorta arising from th e TAVR (Panel A andB). On cross-sectional images prosthetic thrombi were identified on the commissures and the leaflets of the TAVR (Panel C). As a sign of heart failure, pronounced bilateral pleural effusions were visible on axial images (Panel D). Multidetector computed tomography also revealed bilateral severe pneumonia. The patient passed away shortly after the MDCT scan due to sepsis-related multiple organ failure.
Source: European Heart Journal - Category: Cardiology Source Type: research