Abstract
Congenital aortic bicuspid valve can evolve rapidly and at an early age to a severe aortic disease with significant stenosis and regurgitation. Therefore, cardiovascular surgery with mechanical aortic prosthesis implant is the only therapeutic solution. Despite a successful surgical procedure, complications can be numerous, especially post-operatively, as conduction disorders and arrhythmias. Also, given the recent guidelines recommendations to maintain the INR values above 2,5, chronic oral anticoagulation is critical in the long-term prevention of cardioembolic events. Thus, we are presenting the case of a patient diagnosed with a severe aortic disease secondary to a bicuspid aortic valve, who underwent a Bentall surgical procedure, later suffering a wide spectrum of complications, both immediate and late, especially due to long-term subtherapeutic INR values. The particularities of the case reside both in the multitude of complications that occurred in a particular chronological order and in the interfering mechanisms with the anticoagulant therapy.