Critical Limb Ischemia in a Young Patient With a Mechanical Aortic Valve Leading to Bilateral Above-Knee Amputation

Division

West Florida

Hospital

Medical Center of Trinity

Document Type

Case Report

Publication Date

5-15-2021

Keywords

non-compliance, mechanical aortic valve complications, bilateral thrombosis, anti-coagulation, critical limb ischemia

Disciplines

Cardiology | Cardiovascular Diseases | Internal Medicine

Abstract

This case reports a 24-year-old female with prior aortic insufficiency who underwent a mechanical aortic valve replacement with subsequent transient ischemic attacks and documented subtherapeutic international normalized ratio (INR). She presented with pain and bilateral lower extremity pulselessness. Workup showed a supratherapeutic INR, no thrombus on echocardiogram, and computed tomography angiography demonstrating no flow in the bilateral common femoral arteries. Patient failed repeated thrombectomies and had a bilateral above-knee amputation. The patient was suspected to have acute on chronic emboli from the mechanical aortic valve and further testing did not elucidate contributory causes of her critical limb ischemia. We believe this is the first documented case of bilateral lower extremity ischemia due to mechanical valve complications.

Publisher or Conference

Cureus

Link to Full Text

Share

COinS