ABSTRACT
Mitraclip corrects mitral regurgitation in a less invasive way than cardiac surgery. These procedures are becoming widespread with the emergence of new complications. We report a rare case of mitral stenosis associated with acute hemolytic anemia after mitraclip treatment in an 82-year-old patient. The cause of this stenosis in our case is linked to the placement of two clips and an increase gradient in post-procedure. The mechanism of hemolysis could be due to the persistence of mitral leaks resulting in strong collisions against the clip.
Subject(s)
Anemia, Hemolytic/etiology , Mitral Valve Insufficiency/surgery , Mitral Valve Stenosis/etiology , Postoperative Complications/etiology , Surgical Instruments/adverse effects , Acute Disease , Aged, 80 and over , Cardiac Surgical Procedures/instrumentation , Humans , MaleSubject(s)
Anticoagulants/administration & dosage , Anticoagulants/adverse effects , Atrial Appendage/surgery , Atrial Fibrillation/surgery , Heart Diseases/prevention & control , Hematuria/chemically induced , Prostheses and Implants , Thrombosis/prevention & control , Withholding Treatment , Aged , Atrial Fibrillation/complications , Heart Diseases/etiology , Humans , Male , Thrombosis/etiologyABSTRACT
Female infertility treated by ovarian stimulation can lead to arterial thrombosis particularly when ovarian hyperstimulation syndrome emerges. Myocardial infarction have been reported thrice, in one case even before artificial ovulation induction. A 25-year-old female with primary infertility underwent ovarian stimulation and eight days after ovulation induction and intra-uterine insemination suffered from a troponin positive non-ST-elevation myocardial infarction of the inferior wall. Coronary angiogram was normal and contrast-enhanced cardiovascular magnetic resonance imaging confirmed the subendocardial inferior infarct. This protocol included sole triptorelin administration followed by 23 recombinant follicle stimulating hormone injections and concluded by recombinant choriogonadotrophin. There was no ovarian hyperstimulation syndrome. Large biological screening did not retrieve any predisposition for arterial thrombosis. Clinical outcome was excellent. Despite weak causal link, we emphasize that chest pain during ovarian stimulation protocol should rise clinical concern for acute coronary syndrome.
