Status post repair utilizing a #28 gel weave graft, aortic valve replacement utilizing a 27/29 on-x mechanical valve and ligation of the patent ductus arteriosus in (b)(6) 2023, was on coumadin with inr goal 2.5-3.5 for 3 months following valve placement and then decreased to 1.5-2.5 per recommendations from previous studies, inr 2 on arrival.Had been at lower goal for 3 weeks and presented to emergency department with left sided weakness on (b)(6) 2024.Found to have middle cerebral artery, cerebral vascular accident, underwent mechanical thrombectomy (b)(6) 2024.Echo (b)(6) 2024 showed echogenic structure noted within the left atrium along with the intra-atrial septum, not mobile.Transesophageal echocardiography ordered.
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