Cardiopulmonary bypass before general anesthesia in prosthetic valve thrombosis.

Valve obstruction is a lifethreatening complication of mechanical valve prostheses. Emergency operation is mandatory for patients who subsequently develop cardiogenic shock and severe pulmonary edema. In this severely compromised hemodynamic condition, cardiac arrest develops in most of the patients before surgery and just after general anesthesia induction. In one such case, we performed femorofemoral cardiopulmonary bypass with local anesthesia before general anesthesia induction and successfully replaced the thrombosed prosthetic valve, thus avoiding a catastrophic outcome.