I have a 57 years old Hispanic male status post mitral valve replacement with a bioprosthetic valve. Routine post operative TTE showed possible vegetation in the prosthetic valve which was followed by a TEE. TEE confirmed the mobile structures in the ventricular aspect of prothetic mitral valve resemble two remnants of papillary muscles/cordae. The patient was initially prescribed warfarin for possible thrombi/microthrombi. Any role of long-term anti-coagulation?
There is no role for long term oral antocoagulation in bioprosthetc valve if the patient is in sinus rhythm. Oral anti coagulation is indicated only in the initial 3 to 6 months period. Considering the clinical context and the TEE data, the mobile mass identified is unlikely to be a vegetation or a thrombus. Thanks.
Not in my opinion. Probably the two vegetations aren't of thrombotic origin!!!
There is no role of long term anticoagulation in this patient as long as there is no indication or risk factor for future thrombo-embolic events.
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