Stroke secondary to calcific bicuspid aortic valve: Case report and literature review

Mahajan, Nitin; Khetarpal, Vipin; Afonso, Luís

doi:10.1016/j.jjcc.2008.10.011

Cited by 18 publications

(10 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…517 Pathological studies have demonstrated microthrombi on damaged aortic valves, which suggests a possible source for emboli, 518 but the clinical significance is uncertain.…”

Section: 511mentioning

confidence: 99%

Guidelines for the Prevention of Stroke in Patients With Stroke and Transient Ischemic Attack

Kernan¹,

Ovbiagele²,

Black³

et al. 2014

Stroke

4,000

1,326

View full text Add to dashboard Cite

The aim of this updated guideline is to provide comprehensive and timely evidence-based recommendations on the prevention of future stroke among survivors of ischemic stroke or transient ischemic attack. The guideline is addressed to all clinicians who manage secondary prevention for these patients. Evidence-based recommendations are provided for control of risk factors, intervention for vascular obstruction, antithrombotic therapy for cardioembolism, and antiplatelet therapy for noncardioembolic stroke. Recommendations are also provided for the prevention of recurrent stroke in a variety of specific circumstances, including aortic arch atherosclerosis, arterial dissection, patent foramen ovale, hyperhomocysteinemia, hypercoagulable states, antiphospholipid antibody syndrome, sickle cell disease, cerebral venous sinus thrombosis, and pregnancy. Special sections address use of antithrombotic and anticoagulation therapy after an intracranial hemorrhage and implementation of guidelines.

show abstract

“…517 Pathological studies have demonstrated microthrombi on damaged aortic valves, which suggests a possible source for emboli, 518 but the clinical significance is uncertain.…”

Section: 511mentioning

confidence: 99%

Guidelines for the Prevention of Stroke in Patients With Stroke and Transient Ischemic Attack

Kernan¹,

Ovbiagele²,

Black³

et al. 2014

Stroke

4,000

1,326

View full text Add to dashboard Cite

show abstract

“…From existing series, it has become evident that a diseased aortic valve is a source of emboli. The degree of stenosis, calcification and regurgitation can be responsible for embolic stroke by damaging red blood cells through release of adenosine phosphate and thromboplastin with cloth formation [13,14,39] but also through turbulence and by dislodging calcified fragments [39]. These preoperative incidents serve as predictor for postoperative TE events [10,24].…”

Section: Discussionmentioning

confidence: 99%

The Biological Heart Valve in Aortic Position and its Effect on the Brain

Mistiaen¹

2014

CSR

View full text Add to dashboard Cite

Thromboembolic events are a major complication of valve replacement. Most of these occur in the brain, with devastating consequences. Biological heart valve prostheses have been designed to reduce these complications as much as possible. This has the advantage that they require less antithrombotic agents compared to mechanical valves. However, thromboembolic events still do occur. The main question is: are such devices thrombogenic on long-term? For this reason, only long-term results have been included. A literature review reveals that there are several sources of emboli: the diseased native valve itself as well as other cardiovascular conditions such as atrial fibrillation or poor left ventricular function. Annual rate of thromboembolism of different series have been compared as well as the effect of several antithrombotic regimens during the first three postoperative months, since this is the most hazardous period. The results of trans-catheter aortic valve implantation have also been added since this is a way to treat patients who cannot stand the trauma of valve surgery. High age and risk scores make comparison with valve surgery difficult however. In either case, the rate of thromboembolism is rather low. Anticoagulation is probably needed within the first three months. If additional risk factors are present, life-long anticoagulation becomes necessary. However, there are some serious limitations in this review. The most important are the lack of standardization of recording embolic events and the value of possible surrogate parameters such as brain lesions on magnetic resonance imaging and cognitive decline. Large scale randomized controlled trials to identify the best antithrombotic protocol are difficult to design: because of confounding patient-related risk factors, large patient number needed to detect significant differences, and large variations in possible combinations of agents. However, every effort should be made to register every event in an adequate and standardized way.

show abstract

“…Embolization from calcific BAVs may lead to stroke and myocardial infarction. Conservative management with anticoagulation, to treat associated post-stagnation thrombosis, or aortic valve replacement as the treatment, is debatable [97].…”

Section: Thromboembolismmentioning

confidence: 99%

The Bicuspid Aortic Valve

Demir¹

2013

Calcific Aortic Valve Disease

View full text Add to dashboard Cite

Stroke secondary to calcific bicuspid aortic valve: Case report and literature review

Abstract: Embolization from calcific bicuspid aortic valves can lead to stroke and MI. Conservative management with anticoagulation for treatment of associated poststagnation thrombosis or aortic valve replacement as treatment is debatable. This patient was successfully managed with anticoagulation.

Cited by 18 publications

References 9 publications

Guidelines for the Prevention of Stroke in Patients With Stroke and Transient Ischemic Attack

Guidelines for the Prevention of Stroke in Patients With Stroke and Transient Ischemic Attack

The Biological Heart Valve in Aortic Position and its Effect on the Brain

The Bicuspid Aortic Valve

Contact Info

Product

Resources

About