Surgical treatment of prosthetic mechanical valve thrombosis with the aid of high-flow CO2.

The surgical treatment of prosthetic mechanical valve thrombosis involves redo valve replacement and removal of the thrombi layers. The hinges and near-hinge areas of the bi-leaflet mechanical valve are a 'stagnation area' where blood flow is typically unsteady and can give rise to thrombi; however, these zones are not easily accessed with surgical instruments. Here, we present a case in which high-flow CO2 was used to facilitate the removal of microthrombi in the stagnation area around a prosthetic mechanical valve.