Management of Acute Pituitary Apoplexy After Mechanical Aortic Valve Replacement.

Pituitary apoplexy is a clinical syndrome caused by hemorrhage or infarction of the pituitary gland and has been described as a rare complication of cardiac surgery. Management of this complication after mechanical valve replacement is complex, given the need for postoperative anticoagulation and potential neurosurgical resection. This paper presents a case of pituitary apoplexy identified after mechanical root and ascending hemiarch replacement and describes our clinical decision making around anticoagulation selection and optimal surgical timing. The patient underwent successful resection on postoperative day 9 and did not have any major bleeding or valvular thromboembolic complications. Multidisciplinary collaboration was critical to his favorable outcome.