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

BMJ Case Rep. 2024 Jan 30;17(1):e257001. doi: 10.1136/bcr-2023-257001.

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.

Keywords: Neuroimaging; Neurosurgery; Stroke; Venous thromboembolism.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Arterial Occlusive Diseases* / complications
  • Brain Ischemia* / complications
  • Brain Ischemia* / surgery
  • Embolism* / complications
  • Female
  • Humans
  • Ischemic Stroke* / complications
  • Middle Aged
  • Stents
  • Stroke* / surgery
  • Thrombectomy / methods
  • Thrombosis* / diagnostic imaging
  • Thrombosis* / etiology
  • Thrombosis* / surgery
  • Treatment Outcome
  • Tricuspid Valve / diagnostic imaging
  • Tricuspid Valve / surgery