Miguel Álvarez-Mejía, Facultad de Medicina, Pontificia Universidad Javeriana; Departamento de Cardiología, Hospital Universitario San Ignacio; Bogotá D.C., Colombia
Cristian O. Porras-Bueno, Facultad de Medicina, Pontificia Universidad Javeriana; Departamento de Cardiología, Hospital Universitario San Ignacio; Bogotá D.C., Colombia
Jesús A. Beltrán-España, Facultad de Medicina, Pontificia Universidad Javeriana; Departamento de Cardiología, Hospital Universitario San Ignacio; Bogotá D.C., Colombia
Nancy M. Herrera-Leaño, Facultad de Medicina, Pontificia Universidad Javeriana; Departamento de Cardiología, Hospital Universitario San Ignacio; Bogotá D.C., Colombia
Edward A. Cáceres-Méndez, Facultad de Medicina, Pontificia Universidad Javeriana; Departamento de Cardiología, Hospital Universitario San Ignacio; Bogotá D.C., Colombia
Rodrigo Castro-París, Facultad de Medicina, Pontificia Universidad Javeriana; Departamento de Cardiología, Hospital Universitario San Ignacio; Bogotá D.C., Colombia
Edgar G. Ríos, Servicio de Cirugía Cardiovascular, Hospital Universitario San Ignacio, Bogotá D.C., Colombia
Mechanical prosthetic valves in the pulmonary position are rarely used, and their dysfunction, although uncommon, is clinically significant. We report the case of a 34-year-old woman with a history of congenital pulmonary valve dysplasia who underwent mechanical valve replacement. Two years later, she presented with signs of right heart failure. Multimodality imaging, including transthoracic echocardiography, revealed significant stenosis and moderate intraprosthetic regurgitation due to an immobile disc, associated with subtherapeutic INR levels. Surgical exploration identified pannus formation and chronic thrombus. Prosthetic cleaning restored full leaflet mobility and improved the patient’s clinical status. This case highlights the importance of adequate anticoagulation control, the role of multimodality imaging, and timely intervention in the management of mechanical prosthetic valve dysfunction in the pulmonary position.
Keywords: Pulmonary valve. Prosthetic valve dysfunction. Pannus. Thrombosis. Right heart failure. Multimodality imaging.
