On an unknown date, a (b)(6) year old female presented to the hospital with a diagnosis of rheumatic heart disease and severe mitral stenosis.The patient underwent balloon mitral valvotomy(bmv), but it was unsuccessful.On (b)(6) 2019, the patient underwent emergency mitral valve replacement and the mitral valve was replaced with a 23mm sjm masters series valve expanded cuff (sn: (b)(4)).On (b)(6) 2020, the patient presented to the hospital with breathlessness.Her prothrombin time and inr were in therapeutic range(inr was 2.8).However, her echocardiography showed a stuck valve due to acute thrombosis and the patient underwent successful thrombolysis and the patients anticoagulation dose was increased.On (b)(6) 2020, the patient presented with breathlessness again.The patient's prothrombin time was prolonged with prothrombin time test more than 100 seconds.The echocardiography showed an elevated mitral valve gradient.Fluoroscopy was done and it showed immobility of the prosthetic mitral valve leaflet.The patient underwent thrombolysis, but the thrombolysis failed to release the stuck valve.The physician decided to perform a re-do mitral valve replacement.On (b)(6) 2020, the patient underwent the re-do mitral valve replacement surgery and the valve was explanted and replaced with a 25mm epic stented porcine heart valve w/flexfit system.The intra-operative findings showed a stuck aortic side leaflet of the prosthetic valve due to thrombosis.The patient is doing well and was discharged 4 days after surgery.
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