Heart valve mechanical prosthesis: The perfect match until it is not - A case report

Exp Ther Med. 2020 Sep;20(3):2481-2483. doi: 10.3892/etm.2020.8959. Epub 2020 Jun 29.

Abstract

Primary immune thrombocytopenia (ITP), formerly known as idiopathic thrombocytopenia, is defined by a reduced platelet count <50x109 and is clinically manifested through signs and symptoms such as bleeding, ecchymosis and petechiae. Its coexistence with the implantation of the mechanical valves and the necessity of anticoagulation creates an additional risk of bleeding. Although mechanical valves are indispensable in prolonging and improving the quality of life in patients with valvular heart disease, in the context of an additional bleeding risk factor, their presence could represent a threat to life exposing the patient to major complications and leading to death. The purpose of this case report is to discuss the disadvantages and possible fatal complications of the association between mechanical valves and severe thrombocytopenia. A possible solution to these downsides could be found in the future search in regenerative medicine and tissue engineering of heart valves resulting in products that do not require anticoagulation and do not pose a threat to patients with thrombocytopenia.

Keywords: anticoagulation; bleeding; mechanical heart valve; primary immune thrombocytopenia; thrombotic events; vitamin K antagonists.