ABC | Volume 111, Nº4, Octuber 2018

Anatomopathological Correlation Ávila et al. Mechanical cardiac prosthesis, pregnancy and respiratory failure and shock Arq Bras Cardiol. 2018; 111(4):629-634 Figure 7 – Histological section of the mass adhered to the valve prosthesis, constituted by thrombus, with fibrin and moderate amounts of inflammatory cells, without microorganisms. Hematoxylin & eosin staining; objective magnification: 10x. Figure 6 – The mechanical valve prosthesis is seen from the opened left atrium. The left panel shows a massive thrombus occluding almost completely the valvar orifice. After removal of the thrombus, (right panel), it is demonstrated that the prosthesis shows adequate opening. Comment Although the main problem that led to the death of the patient was thrombosis of the mitral valve prosthesis – emphasizing the difficulty of managing the coagulation system during pregnancy – it is worth mentioning that the lungs were also very affected, with a pattern of organizing pneumonia. It is important to emphasize that the diagnosis of “organizing pneumonia” refers to a picture that may follow not only classical bacterial pneumonia, but also several other situations, such as viral infections, exposure to toxic inhalants and others. 7 However, marked congestion, albeit sudden, is not listed among the possible causes of this process. Therefore, in the present case, organizing pneumonia must have been due to the respiratory picture, possibly an infectious one, whether viral or bacterial, which was already present when the patient was admitted at the institution. 633