Unusual redo mitral valve replacement for bleeding in Glanzmann thrombasthenia

Abstract

We report the case of 23-year-old man with mitral valve regurgitation and Glanzmann thrombasthenia, who underwent mechanical mitral valve replacement. Warfarin therapy was devastating, causing bilateral hemothorax, pericardial effusion, gastrointestinal bleeding, and hematuria. Redo mitral valve replacement with a biological prosthesis was required to resolve this critical situation. To our knowledge, this is the first report of mitral valve replacement in Glanzmann thrombasthenia, highlighting the danger of oral anticoagulation in this pathology.

Perioperative management of a patient with glanzmann's thrombasthenia for mitral valve repair under cardiopulmonary bypass

“…have reported a case of redo MVR with a bioprosthetic valve for warfarin-related catastrophic bleeding after mitral valve replacement in their patient with GT. [ 5 ] Another 8-year-old male child with GT underwent successful VSD repair. Before the operation, he received 6 units of platelets and intravenous desmopressin at 0.3 μg/kg every 2 h for 4 doses.…”

Anticoagulation in Patients with Platelet Disorders

“…Garcia-Villarreal et al described a Glanzmann thrombasthenia patient undergoing prosthetic mitral valve replacement who developed severe bleeding complications during postsurgery anticoagulation including severe hematuria and gastrointestinal bleeds. 90 Only the shift to a biologic valve prosthesis could control the situation as anticoagulation could be stopped afterward. This case illustrates the relevance to accurately plan such procedures and to ascertain whether less thrombogenic cardiac or arterial devices can be implanted to avoid long-term anticoagulation after the procedure.…”