# Successful Reversal of Late, Severe Thrombotic Bioprosthetic Mitral Valve Stenosis With Anticoagulation Therapy

## TL;DR

A 78-year-old woman's severe heart valve blockage was successfully treated with anticoagulation therapy, showing it can reverse late valve thrombosis.

## Contribution

Demonstrates apixaban's effectiveness in reversing late, severe bioprosthetic mitral valve stenosis due to thrombosis.

## Key findings

- Anticoagulation with apixaban reversed severe thrombotic stenosis in a late bioprosthetic valve case.
- The case suggests bPVT should be considered as an alternative to valve degeneration in late stenosis.
- Apixaban therapy may be a viable treatment for managing thrombotic bioprosthetic valve stenosis.

## Abstract

Late bioprosthetic valve thrombosis (bPVT) is a rare and potentially life-threatening complication following valve replacement with thrombus formation leading mostly to valvular stenosis or embolic phenomena. Clinically, it manifests as symptoms of fatigue, dyspnea, or reduced exercise capacity. The existing treatment guidelines lack clear recommendations for managing this specific presentation. In this case study, we present a distinct clinical scenario wherein the use of anticoagulation, specifically apixaban, successfully reversed very late, severe thrombotic stenosis in a 78-year-old woman with a Medtronic Hancock II porcine mitral valve (Dublin, Ireland). This case highlights the need to consider bPVT as an alternative etiology to valve degeneration in the setting of late bioprosthetic valve stenosis. Additionally, it demonstrates how apixaban therapy may serve as a viable treatment modality in these scenarios.