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  • Case of postoperative mitral and tricuspid valve repair with large vessel occlusion ischaemic stroke: successfully treated with mechanical thrombectomy extracting subocclusive thrombus containing foreign material

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Neurology
Case of postoperative mitral and tricuspid valve repair with large vessel occlusion ischaemic stroke: successfully treated with mechanical thrombectomy extracting subocclusive thrombus containing foreign material
  1. Momodou G Bah1,
  2. Daniel Vollhaber2,
  3. Leanne Lin3,
  4. Zachary Wilseck1,
  5. Joseph J Gemmete3,
  6. Frank G Conyers4,
  7. Joseph F Carrera4 and
  8. Neeraj Chaudhary2,3,4,5
  1. 1Human Medicine, Michigan State University College of Human Medicine, East Lansing, Michigan, USA
  2. 2Neurosurgery, University of Michigan, Michigan Medicine, Ann Arbor, Michigan, USA
  3. 3Radiology, University of Michigan, Michigan Medicine, Ann Arbor, Michigan, USA
  4. 4Neurology, University of Michigan, Michigan Medicine, Ann Arbor, Michigan, USA
  5. 5Otorhinolaryngology, University of Michigan, Michigan Medicine, Ann Arbor, Michigan, USA
  1. Correspondence to Dr Neeraj Chaudhary; neerajc{at}med.umich.edu

Abstract

A woman in her 60s with a history of prior ischaemic stroke developed acute onset slurring of speech, left-sided facial droop and left-sided weakness and was found on CT angiography to have a subocclusive thrombus multiple days after undergoing mitral and tricuspid valve repair surgery. A stent retriever and aspiration catheter were used to successfully remove the subocclusive material which was identified as ‘foreign material’ on histology. Ultimately, the patient demonstrated clinical improvement.

Foreign material embolism is a rare but serious complication that can occur during or after mitral and tricuspid valve repair surgery. It can cause ischaemic stroke and prompt recognition and immediate intervention are necessary to prevent serious complications.

The case report highlights the successful use of stent retriever-mediated suction thrombectomy to remove a foreign material embolism in a patient. It emphasises the importance of timely intervention to prevent serious complications and shows the potential benefits of this technique.

  • Venous thromboembolism
  • Stroke
  • Neurosurgery
  • Neuroimaging

https://doi.org/10.1136/bcr-2023-257001

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    Footnotes

    • Twitter @GobiBah1, @dvollhaber

    • Contributors The following authors were responsible for drafting of the text, sourcing and editing of clinical images, investigation results, drawing original diagrams and algorithms and critical revision for important intellectual content: MGB, NC and DV were responsible for concept, manuscript design and drafting of the text. LL was responsible for editing and generating of clinical images. ZW, LL, JG, GC, JC, NC and DV were involved in the patient management. All authors reviewed and contributed to the draft and manuscript writing. The following authors gave final approval of the manuscript: JG and NC gave final approval of the manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.