A 51-year-old female underwent redo mitral valve replacement with a pericardial bioprosthesis because of acute thrombotic obstruction of a mechanical valve, in spite of adequate anticoagulation with warfarin. Her protein C level was 24% of the normal value and protein S was reduced to 54% of normal.
Get full access to this article
View all access options for this article.
References
1.
VitaleNRenzulliACerasuoloFCarusoAFestaMde LucaLProsthetic valve obstruction: thrombolysis versus operation. Ann Thorac Surg1994;57: 365–70.
MartinellJFraileJArtizVCortinaJFresnedaPRabagoG. Reoperations for left-sided low-profile mechanical prosthetic obstructions. Ann Thorac Surg1987;43: 172–5.
4.
EdmundsLHJr. Thrombotic and bleeding complications of prosthetic heart valves. Ann Thorac Surg1987;44: 430–45.
5.
RenzulliADe LucaLCarusoAVerdeRGalzeranoDCotrufloM. Acute thrombosis of prosthetic valves: a multivariate analysis of the risk factors for a life-threatening event. Eur J Cardio-thorac Surg1992;6: 412–20.
6.
StenfoJ. A new vitamin K-dependent protein: purification from bovine plasma and preliminary characterization. J Biol Chem1976;281: 355–63.
7.
WalkerFJ. Protein S and the regulation of activated protein C. Thromb Haemost1984;10: 131–8.
8.
MiletichJShermanLBrozeGJr. Absence of thrombosis in subjects with heterozygous protein C deficiency. N Engl J Med1987;317: 991–6.
