Nonbacterial thrombotic endocarditis as a surgical complication in a patient status post mitral valve repair with patent foramen ovale closure

First described in the 1800s, nonbacterial thrombotic endocarditis (NBTE) was initially dismissed as clinically insignificant, a post-mortem diagnosis or complication seen in patients suffering from malignancies, hypercoagulable states or autoimmune disorders. While occasional studies and reports over the last several decades have proven it to be a major clinical problem with serious sequela, it remains underdiagnosed and underreported. We present the case of a 44 year-old male with recurrent transient ischemic attacks who developed NBTE status post surgical repair of a patent foramen ovale and mitral valvulopathy, illustrating a unique presentation and etiology that has rarely been mentioned or described in medical literature. Keywords: nonbacterial thrombotic endocarditis | mitral valve repair | patent foramen ovale | surgical complication | marantic | stroke | anticoagulation
Case presentation Patient X was a 44 year-old male with a past medical history of mitral valve regurgitation and patent foramen ovale status post surgical correction of both conditions two [...]