RT Journal Article SR Electronic T1 Fulminant thrombosis of mechanical mitral valve prosthesis JF Heart JO Heart FD BMJ Publishing Group Ltd and British Cardiovascular Society SP e16 OP e16 DO 10.1136/heart.86.5.e16 VO 86 IS 5 A1 M Zielinska A1 N F Haegele A1 C Firschke YR 2001 UL http://heart.bmj.com/content/86/5/e16.abstract AB In patients with prosthetic heart valves non-cardiac surgery may require temporary discontinuation of oral anticoagulation. Although the risk of valve related thromboembolic complications may generally be only slightly increased during the short perioperative period, in the presence of certain risk factors, replacement of oral anticoagulation with heparin is recommended. In the presented patient, unusually fulminant and finally fatal thrombosis of a mechanical mitral valve prosthesis developed within only 48 hours after non-cardiac surgery despite heparin treatment. The thrombosis was triggered by clinical conditions favouring a hypercoagulable state. This report dramatically shows that despite improvements in prosthetic heart valve design and in the management of anticoagulation, thrombosis remains one of the most dangerous complications after valve replacement with a mechanical prosthesis.