[Abdominal Apoplexy after Mitral Valve Replacement Due to Infective Endocarditis;Report of a Case].

A 52-year-old woman with mitral valve insufficiency and congestive heart failure due to infective endocarditis was treated by mitral valve replacement with a mechanical valve. Warfarin was started on postoperative day (POD) 3, but sudden onset of anemia with left abdominal pain presented on POD 8. Abdominal apoplexy was diagnosed by computed tomography (CT) and ultrasonographic imaging, but active bleeding was not evident. She was hemodynamically stable and her prothrombin time-international normalized ratio(PT-INR) at that time was 1.70 (compared with 2.56 on POD 7). To avoid repeated bleeding, PT-INR was controlled at around 1.5. Other complications did not arise, and thereafter her postoperative course was favorable.