Infarct of the spleen after valve replacement

[Guest]

Our 20 year old son had his aortic valve replaced 13 months ago. Now, out of the blue he had severe abdominal pain and was diagnosed with Infarct of half of his spleen ( blood clot in the spleen, half of spleen tissue died). He's having lots of medical tests done trying to figure out why he got this blood clot. It's not injury related. They are mainly focusing on his heart valve, thinking it caused the clot. Tests have not found anything conclusive yet. Has anyone else heard of this happening? Thank you.

 

[pellicle]

Hi

sorry to hear of that difficulty

as you can imagine its not a common thing.

What valve was put in?

Was he on warfarin / coumadin?

best wishes

 

[LondonAndy]

wow - that does sound serious, and surprising if he is on an anti-coagulant like warfarin. I have no medical qualification, but will mention an issue I experienced that my Cardiologist thinks is down to my mechanical valve in case relevant. I had mild anaemia, and he thought that the valve may be damaging blood cells as it closes. They prescribed me iron supplements to compensate. After a trial period of taking the supplements, once I stopped taking them the anaemia returned, so I am back on the supplements.

Assuming that he was on warfarin, was his INR usually in his therapeutic range?

 

[dick0236]

I had a similar problem a few years after my surgery. I have a mechanical aortic valve and am on the drug warfarin. I had a clot go to my brain and lost some of my vision. Mine was due to my mismanagement or the drug warfarin. I have gone 40+ years since my stroke without any further problems.......simply by paying attention to my use of warfarin.

 

[Catie]

I don't have insight on the issues, but I'm sure this has been a frightening development. I hope your son makes a full and speedy recovery.

 

[anne casey]

Thank you all for your thoughts and concern. He has a tissue valve. It was his choice, he wanted to be able to play sports yet and not have to take blood thinners. So no, he is not on blood thinners. I'm assuming that may change now... He will have a TEE ultra sound on Monday and the blood culture will be back then to see I've has an infection of the valve. He's been having fingertip pain from time to time over the last few months and the pain will move from different fingers every day. Really weird. We mentioned this to Drs. too. Just wondering if that indicates anything. No discoloration or bumps, just pain on pads of some fingers, then the next day it will be a couple different fingers. Then he'll go days without the fingertip pain. He's had so many blood tests, cT scan, echo, ekg's...thankfully, they all look good.

 

[pellicle]

Hi

... He has a tissue valve.

well that rules out where I was sort of heading ... so prostheses generated clot is far less likely.

That it was at 13 months sort of rules out (to my understanding) any blood clots around the valve from surgery, as they would have likely broken lose by now too.

He's been having fingertip pain from time to time over the last few months and the pain will move from different fingers every day. Really weird. We mentioned this to Drs. too. Just wondering if that indicates anything.

indeed ... weird ... as to implications or significance nothing I know of ...

the only thing I'd suggest is to take some occasional d-dimer tests soon after he's played sport.
https://en.wikipedia.org/wiki/D-dimer
That would make it perhaps clearer if he was getting clots caused by the valve ... certainly its less common with a tissue valve but I would still pursue that as a possibility simply because there seem to be no other significant other leads.

I hope you find it before any other trauma occurs.

Best Wishes

 

[ejc61]

Has he been running any fevers on and off? I guess that blood tests may include a blood culture?

 

[anne casey]

Update: blood culture was negative. They did a TEE echo, 1 st one he ever had. It showed a "wad" on one of the leaflets. It does not effect the function of the leaflet and it does not move. Perhaps it's scar tissue, we were told and maybe a clot formed or fell of of that. Everything else looks good. He's now on blood thinners as a percausion for at least 6 mo. Follow up appt. in 1mo. His spleen pain is gone and is "back to normal." Many thanks again!