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(Chest. 1970;57:151-155.)
© 1970 American College of Chest Physicians

Fatal Thrombosis of the Starr-Edwards Mitral Valve Prosthesis Associated with Bacterial Endocarditis

Diagnostic Significance of a Disappearing Prosthetic Click

Tsung O. Cheng M.D., F.C.C.P.1; Vithal Kinhal M.D.2; and David A. Tice M.D.3

1 Chief, Cardiovascular Laboratory, VA Hospital and Clinical Assistant Professor of Medicine, State University of New York Downstate Medical Center College of Medicine, Brooklyn, New York
2 Cardiovascular Laboratory, VA Hospital, Brooklyn
3 Chief, Surgical Service, VA Hospital, New York

A case of fatal thrombosis of Starr-Edwards mitral valve prosthesis associated with bacterial endocarditis is presented. The role of inadequate anticoagulation and bacterial endocarditis in the formation of massive thrombus on the valve prosthesis is discussed. The detection of disappearance of a distinct click sound in a patient with a previously functioning Starr-Edwards mitral valve prosthesis should arouse immediate suspicion of massive thrombosis of the prosthesis. The latter should constitute a surgical emergency as fatal outcome inevitably ensues unless the thrombosed prosthesis is replaced.






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Copyright © 1970 by the American College of Chest Physicians.